Individual
CARMENETHA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1724 N BURNSIDE AVE # 7, GONZALES, LA 70737-2157
(225) 644-8565
Mailing address
1724 N BURNSIDE AVE # 7, GONZALES, LA 70737-2157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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