Individual
KRISTA KAY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 232-2332
Mailing address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 232-2332
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19216-130
WI
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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