Individual
DESTINEE SHARAE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 N MICHIGAN AVE, STE 1025, CHICAGO, IL 60602-3756
(312) 521-0167
(708) 843-9384
Mailing address
1245 S MICHIGAN AVE UNIT 161, CHICAGO, IL 60605-2408
(312) 521-0167
(708) 843-9384
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149017231
IL
Other
Enumeration date
12/26/2014
Last updated
04/25/2022
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