Individual
AMBER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS, SAP
Contact information
Practice address
822 OLD WINSTON RD, SUITE 5, KERNERSVILLE, NC 27284
(336) 558-0219
Mailing address
822 OLD WINSTON RD, SUITE 5, KERNERSVILLE, NC 27284-7106
(336) 558-0219
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22505
NC
Other
Enumeration date
01/14/2016
Last updated
03/15/2017
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