Individual
LISA A. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1660 OLD PECOS TRL STE A, SANTA FE, NM 87505-4778
(651) 313-8080
Mailing address
5426 STILL BROOKE AVE NW, ALBUQUERQUE, NM 87120-3384
(620) 778-2269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0470
NM
Other
Enumeration date
03/01/2022
Last updated
07/26/2024
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