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Individual
MR. WILLIAM KENNETH MOORE III
Active
Individual
MR. WILLIAM KENNETH MOORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR II, MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
SC
Enumeration date
03/14/2018
Last updated
03/14/2018
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