Individual
MS. MELLAKNESE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC-I, MS,ICADC, BSB
Contact information
Practice address
3785 E SUNSET RD, LAS VEGAS, NV 89120-6259
(702) 482-9620
Mailing address
9918 SHADOW GROVE AVE, LAS VEGAS, NV 89148-4608
(702) 935-0025
(702) 935-0008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1501
AR
101YP2500X
Professional Counselor
Primary
C15180
NV
Other
Enumeration date
03/04/2020
Last updated
02/12/2024
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