Individual
MS. TIANNA RAQUEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHC-LP
Contact information
Practice address
1720 NOSTRAND AVE, BROOKLYN, NY 11226-6456
(347) 973-3119
Mailing address
PO BOX 1342, VALLEY STREAM, NY 11582-1342
(347) 998-0824
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
05/17/2024
Last updated
05/24/2024
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