Individual
MR. DAVID BRIAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
3501 LAKE EASTBROOK BLVD SE, SUITE 258, GRAND RAPIDS, MI 49546-5938
(616) 719-0194
Mailing address
6845 TERRA COTTA DR SE, CALEDONIA, MI 49316-8005
(616) 450-1590
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801085397
MI
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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