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Individual
DUSTIN BURSON MOORE
Active
Individual
DUSTIN BURSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-9658
ID
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/18/2023
Last updated
07/19/2023
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