Individual
KIMBERLY DAWN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LIMHP, CPC
Contact information
Practice address
6315 AYLESWORTH AVE, LINCOLN, NE 68505-1276
(402) 416-1304
(402) 347-0909
Mailing address
6315 AYLESWORTH AVE, LINCOLN, NE 68505-1276
(402) 416-1304
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2101
NE
101YM0800X
Mental Health Counselor
Primary
1614
NE
Other
Enumeration date
04/10/2019
Last updated
09/17/2019
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