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Individual

KATHLEEN MARY MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1218 GRIEGOS RD NW, ALBUQUERQUE, NM 87107-3752
(505) 342-5450
Mailing address
315 ARNO ST SE, ALBUQUERQUE, NM 87102-3514
(505) 710-2209

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05567
NM

Other

Enumeration date
08/08/2011
Last updated
08/08/2011
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