Individual
INGRID MARIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/27/2010
Last updated
03/16/2017
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