Individual
JULIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6858
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6858
LICENSE
SC
05
—
RHC549
—
SC
05
—
SW1099
—
SC
Enumeration date
08/17/2010
Last updated
01/06/2023
Update your record
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