Individual
AMANDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
2121 7TH ST, PARKERSBURG, WV 26101-3803
(304) 485-1721
Mailing address
2121 7TH ST, PARKERSBURG, WV 26101-3803
(304) 485-1721
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00945295
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP00945295
LGSW
WV
Enumeration date
10/23/2019
Last updated
10/23/2019
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