Individual
MR. DONALD R MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW CAAC
Contact information
Practice address
5470 CHENE ST, DETROIT, MI 48211-2746
(313) 875-5521
Mailing address
3393 OAKMAN BLVD, DETROIT, MI 48238-4200
(313) 875-5521
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/23/2008
Last updated
05/03/2010
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