Individual
MELANIE RENEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
396 YELLOWSTONE AVE, POCATELLO, ID 83201-4572
(385) 985-6354
Mailing address
561 RAVEN WAY, CHUBBUCK, ID 83202-1971
(385) 985-6354
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4671296
ID
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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