Individual
MICHAEL LEWIS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
3 W STIMSON AVE, ATHENS, OH 45701-2679
(740) 592-3600
Mailing address
3 W STIMSON AVE, ATHENS, OH 45701-2679
(740) 592-3600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E.0500676
OH
Other
Enumeration date
12/04/2006
Last updated
03/25/2008
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