Individual
EVAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 692-6622
(309) 692-6952
Mailing address
6615 N BIG HOLLOW RD, PEORIA, IL 61615-2450
(309) 692-6622
(309) 692-6952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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