Individual
MRS. DANIELLE CLARK MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CRC, LPCA
Contact information
Practice address
500 W 4TH ST STE 203, WINSTON SALEM, NC 27101-2782
(336) 391-1601
Mailing address
5510 BROOKFIELD RIDGE DR, WINSTON SALEM, NC 27105-1757
(336) 391-1601
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A13571
NC
225C00000X
Rehabilitation Counselor
Primary
00282458
NC
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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