Individual
MRS. KIMBERLY JEAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.S.W.
Contact information
Practice address
901 MARTIN ST, CLARKSVILLE, TN 37040-4090
(931) 503-4600
(931) 503-4620
Mailing address
2016 SHANNAHAN DR, APT B, FORT CAMPBELL, KY 42223-1104
(931) 802-3869
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000008076
TN
Other
Enumeration date
01/25/2010
Last updated
01/25/2010
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