Individual
MR. TIMOTHY HOWARD MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
3040 N UNIVERSITY AVE, SUITE 2, DECATUR, IL 62526-1391
(217) 872-1700
(217) 872-1366
Mailing address
3040 N UNIVERSITY AVE, SUITE 2, DECATUR, IL 62526-1391
(217) 872-1700
(217) 872-1366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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