Individual
MR. NOLAN KEITH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
20510 KENTFIELD ST, DETROIT, MI 48219-1446
(313) 570-0832
(313) 822-2664
Mailing address
20510 KENTFIELD ST, DETROIT, MI 48219-1446
(313) 570-0832
(313) 822-2664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401003213
MI
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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