Individual
MS. CAROLYN R. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
50 STUTZ BEARCAT DR, SUITE 2, SEDONA, AZ 86336-5268
(928) 300-4539
Mailing address
50 STUTZ BEARCAT DR, SUITE 2, SEDONA, AZ 86336-5268
(928) 300-4539
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-10034
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0913070
BCBS OF AZ NON-CONTRACTED
AZ
Enumeration date
04/16/2007
Last updated
07/08/2007
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