Individual
DANA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
950 CANYON RD., SANTA FE, NM 87501
(617) 417-7757
Mailing address
PO BOX 442, SANTA FE, NM 87504
(617) 417-7757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0101
NM
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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