Individual
CECELIA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4998 W BROAD ST STE 104, COLUMBUS, OH 43228
(614) 752-8051
Mailing address
1515 E BROAD ST, COLUMBUS, OH 43205-1550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
167486
OH
Other
Enumeration date
02/26/2018
Last updated
05/24/2021
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