Individual
MRS. TIFFANY ANNETTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5 W PEARCE BLVD, WENTZVILLE, MO 63385-1415
(636) 344-6572
Mailing address
312 PLEASANT MEADOWS DR, WENTZVILLE, MO 63385-2672
(636) 344-6572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2003019174
MO
Other
Enumeration date
07/28/2006
Last updated
08/17/2020
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