Doctor Name: | MS. SUZANNE PEERS MOORE |
NPI Number: | 1982964821 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW-CP |
License Number: | 4903 |
Business Practice Address: | 93 Carey St Elberton, GA - 306351435 |
Business Phone Number: | 8645121810 |
Business Fax Number: | 8645128619 |
Mailing Address: | 93 Carey Street, ELBERTON |
State: | GA |
Postal Code: | 30635 |
Phone Number: | 8645121810 |
Fax Number: | 8645128619 |
NPI Enumeration Date: | 05/25/2012 |
NPI Last Update Date: | 05/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4903 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |