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Organization
LISA J MOORE LLC
Active
Organization
LISA J MOORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH J TUDOR LMHC (OWNER)
(904) 269-2931
Entity
Organization
Contact information
Practice address
1409 KINGSLEY AVE STE 9D, ORANGE PARK, FL 32073-4580
(904) 571-8701
(904) 571-8701
Mailing address
1409 KINGSLEY AVE STE 9D, ORANGE PARK, FL 32073-4580
(904) 571-8701
(904) 571-8701
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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