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Individual
BRENDA MOORE
Active
Individual
BRENDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00002285
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101460
—
WA
Enumeration date
08/28/2017
Last updated
11/21/2019
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