Doctor Name: | PAMELA MICHELLE MOORE-HARDISON |
NPI Number: | 1871839845 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA, LCASA, LCSWA |
License Number: | 3185-A |
Business Practice Address: | 1198 Grey Farm Rd Jamesville, NC - 278469630 |
Business Phone Number: | 2527419119 |
Business Fax Number: | 2527419119 |
Mailing Address: | 1198 Grey Farm Rd, JAMESVILLE |
State: | NC |
Postal Code: | 278469630 |
Phone Number: | 2527991916 |
Fax Number: | 2527419119 |
NPI Enumeration Date: | 12/19/2012 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 3185-A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |