Individual
TAMARA NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
100 CENTRE ON THE LK, LAKE ST LOUIS, MO 63367-1369
(314) 323-7811
Mailing address
5426 FOREST CREEK DR APT F, HAZELWOOD, MO 63042-3744
(314) 323-7811
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2023007047
MO
Other
Enumeration date
02/22/2023
Last updated
03/04/2023
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