Individual
DAVID MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
57340 ALPHA DR, GOSHEN, IN 46528-7808
(574) 621-3229
Mailing address
57340 ALPHA DR, GOSHEN, IN 46528-7808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007612A
IN
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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