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Individual

HOPE MARIE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1090 GOAT SPRING RD, TAOS, NM 87571
(575) 758-6900
(575) 751-5219
Mailing address
PO BOX 1846, TAOS, NM 87571-1846
(575) 758-7824
(575) 758-3346

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
M-12005
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
72150041
NM
Enumeration date
12/07/2021
Last updated
12/07/2021
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