Individual
ELLANA C MOORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW, LCSW, CAP
Contact information
Practice address
1463 OAKFIELD DR., SUITE 113, BRANDON, FL 33511
(863) 248-3300
(863) 534-7028
Mailing address
4422 E COLUMBUS DR., TAMPA, FL 33605
(863) 519-0575
(863) 534-7028
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2126L
FL
104100000X
Social Worker
Primary
SW5385
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070869100
—
FL
01
—
216576000
MAGELLAN
FL
01
—
Z2789
BCBS
FL
Enumeration date
09/26/2005
Last updated
01/18/2012
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