Individual
LISA C Z MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2211 MAYFAIR DR STE 409, OWENSBORO, KY 42301-4570
(270) 417-7980
(270) 417-7989
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1666
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100335750
—
KY
Enumeration date
11/25/2008
Last updated
03/27/2024
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