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Individual
SONYA GLYN MOORE
Active
Individual
SONYA GLYN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. , LADAC II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
LDC0000001260
TN
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q028453
—
TN
Enumeration date
11/04/2014
Last updated
04/01/2025
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