Individual
MRS. MARIA A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ICS
Contact information
Practice address
2319 W CAPITOL DR, MILWAUKEE, WI 53206-1919
(414) 442-2033
(414) 442-2167
Mailing address
2319 W CAPITOL DR, MILWAUKEE, WI 53206-1919
(414) 442-2033
(414) 442-2167
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15431-134
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15585-132
WI
Other
Enumeration date
08/19/2013
Last updated
03/17/2017
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