Individual
REBECCA LYNN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
125 BURBERRY DR, WILLIAMSTON, SC 29697-8515
(864) 625-0670
Mailing address
125 BURBERRY DR, WILLIAMSTON, SC 29697-8515
(251) 269-0727
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10751
SC
1041C0700X
Clinical Social Worker
Primary
13910
SC
Other
Enumeration date
07/03/2017
Last updated
03/13/2021
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