Individual
MARISSA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C.1700197
OH
101YP2500X
Professional Counselor
Primary
E.2001980
OH
171M00000X
Case Manager/Care Coordinator
CDCA.150752
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3293725
—
OH
Enumeration date
11/20/2017
Last updated
12/14/2020
Update your record
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