Individual
STEPHANIE JILL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MH
Contact information
Practice address
5421 W 41ST ST STE 207, SIOUX FALLS, SD 57106-1300
(855) 888-8627
(605) 427-0831
Mailing address
5421 W 41ST ST STE 207, SIOUX FALLS, SD 57106-1300
(855) 888-8627
(605) 427-0831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
LPC-20418
SD
101YP2500X
Professional Counselor
LPC-20418
SD
Other
Enumeration date
10/09/2012
Last updated
05/03/2024
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