Individual
BETH DALLAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11557
SC
Other
Enumeration date
05/11/2018
Last updated
07/25/2018
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