Individual
CARLTON J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
828 S CARAWAY RD APT 216B, JONESBORO, AR 72401-4492
(513) 901-8921
Mailing address
828 S CARAWAY RD APT 216B, JONESBORO, AR 72401-4492
(513) 901-8921
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
267954789657
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2367856
—
AR
Enumeration date
04/28/2021
Last updated
04/28/2021
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