Individual
CANDYCE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13931 VAN NESS AVE, GARDENA, CA 90249-2941
(310) 768-8018
Mailing address
13931 VAN NESS AVE, GARDENA, CA 90249-2941
(310) 768-8018
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1238741213
CA
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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