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Individual

CAROLE WHITAKER MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, BCD

Contact information

Practice address
110 UNION BELLE BLVD, SALTILLO, MS 38866-0000
(662) 869-3042
(662) 869-3405
Mailing address
110 UNION BELLE BLVD, SALTILLO, MS 38866-0000
(662) 869-3042
(662) 869-3405

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C0206
MS

Other

Enumeration date
04/13/2012
Last updated
04/13/2012
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