Individual
MR. JAMES EDDIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-III
Contact information
Practice address
2319 W CAPITOL DR, MILWAUKEE, WI 53206-1919
(414) 744-5370
(414) 744-9052
Mailing address
5707 W AUER AVE, MILWAUKEE, WI 53216-3135
(414) 444-3883
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2041
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39369400
—
WI
Enumeration date
01/30/2007
Last updated
03/16/2015
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