Individual
ANTHONY BRYANT MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1016 S MADISON ST, SUITE A, DU QUOIN, IL 62832-2442
(618) 542-4357
(618) 542-3442
Mailing address
301 W ELM ST APT 3, CARBONDALE, IL 62901-2765
(618) 542-4357
(618) 542-3442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178010379
IL
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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