Individual
KATHLEEN A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LLPC
Contact information
Practice address
1221 W LAKETON AVE, MUSKEGON, MI 49441-2866
(231) 759-7909
(231) 759-8618
Mailing address
1221 W LAKETON AVE, MUSKEGON, MI 49441-2866
(231) 759-7909
(231) 759-8618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401011331
MI
101YP2500X
Professional Counselor
Primary
6401011331
MI
Other
Enumeration date
02/10/2010
Last updated
02/10/2010
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