Individual
LYDIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
1576 MERRITT BLVD, DUNDALK, MD 21222-2132
(443) 530-6533
Mailing address
109 N UNION AVE APT 6, HAVRE DE GRACE, MD 21078-3025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP12785
MD
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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