Individual
CANDICE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MA
Contact information
Practice address
123 E HWY 6, UNIT B, VALPARAISO, IN 46383
(773) 269-7560
Mailing address
123 E HWY 6, UNIT B, VALPARAISO, IN 46383
(773) 269-7560
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.018752
IL
101YP2500X
Professional Counselor
Primary
178.018752
IL
Other
Enumeration date
05/05/2023
Last updated
05/09/2023
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