Individual
MS. VICKI LYNNETTE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC-S, LCDC, NCC
Contact information
Practice address
1701 GATEWAY BLVD, SUITE 405, RICHARDSON, TX 75080-3572
(214) 532-6527
(972) 644-5512
Mailing address
1701 GATEWAY BLVD, SUITE 405, RICHARDSON, TX 75080-3572
(214) 532-6527
(972) 644-5512
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
65206
TX
Other
Enumeration date
11/10/2010
Last updated
11/06/2013
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