Individual
LORI D MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1302 CALLE DE LA MERCED, SUITE H, ESPANOLA, NM 87532-2624
(505) 474-0081
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0121941
NM
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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