Individual
DALYNN N MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4840
(208) 359-9010
Mailing address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4840
(208) 359-9010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC5604
ID
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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