Individual
MICHELLE KAY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
427 12TH ST, PLUMMER, ID 83851-4000
(208) 686-1931
Mailing address
PO BOX 388, PLUMMER, ID 83851-0388
(208) 686-1931
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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