Individual
MR. GARY L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3260 N HAYDEN RD, SUITE 112, SCOTTSDALE, AZ 85251-6649
(480) 804-0326
(480) 804-0083
Mailing address
2120 S MCCLINTOCK DR, SUITE 105, TEMPE, AZ 85282-2692
(480) 804-0326
(480) 804-0083
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11516
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC- 11516
AZ LPC
AZ
Enumeration date
04/16/2009
Last updated
09/10/2013
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