Individual
LEVI MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10530 W LANCELOT AVE, TELEHEALTH ONLY, BOISE, ID 83704-5249
(831) 251-1216
Mailing address
10530 W LANCELOT AVE, BOISE, ID 83704-5249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
10/08/2025
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