Individual
DIANA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, LMHC
Contact information
Practice address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
(260) 744-4326
(260) 744-0188
Mailing address
2712 S CALHOUN ST, FORT WAYNE, IN 46807-1402
(260) 744-4326
(260) 744-0188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000338A
IN
106H00000X
Marriage & Family Therapist
35001380A
IN
Other
Enumeration date
02/07/2007
Last updated
09/11/2025
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