Individual
LAURA JEANNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2050 WILLOW CREEK RD, PRESCOTT, AZ 86301-5389
(623) 202-2521
(623) 213-7570
Mailing address
4 PERKINS DR, PRESCOTT, AZ 86301-8458
(928) 710-3439
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC22509
AZ
Other
Enumeration date
09/03/2020
Last updated
11/20/2024
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