Individual
MS. PATRICIA A. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
520 N HAINES ST, BOISE, ID 83712-8013
(208) 338-0758
Mailing address
520 N HAINES ST, BOISE, ID 83712-8013
(208) 338-0758
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-29393
ID
Other
Enumeration date
08/07/2006
Last updated
01/10/2011
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