Individual
GERTRUDE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RSW, CAC, CCGC
Contact information
Practice address
CLSH UNIT 6-WING D, PINEVILLE, LA 71360
(318) 441-5900
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1263
LA
104100000X
Social Worker
Primary
5025
LA
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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