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Individual

MRS. KRISSA L MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
23 DEASY DR, NEWARK, DE 19702-2750
(856) 397-4628
Mailing address
PO BOX 173, BEAR, DE 19701-0173
(856) 397-4628

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37PC00702400
NJ
101YP2500X
Professional Counselor
Primary
PC-0011189
DE

Other

Enumeration date
12/10/2019
Last updated
12/18/2024
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