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Individual
STEPHEN MOORE
Active
Individual
STEPHEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8005587-3501
UT
1041C0700X
Clinical Social Worker
Primary
8005587-3501
UT
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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