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Individual

CARLY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 906-4623
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 906-4623
(619) 906-4564

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
62871
CA

Other

Enumeration date
08/25/2015
Last updated
10/02/2015
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