Individual
LACEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
131 DELAWARE AVE, WOODBURY, NJ 08096
(856) 537-5081
(856) 415-7574
Mailing address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 693-5775
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06935200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000691
—
NJ
Enumeration date
05/23/2024
Last updated
06/26/2024
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