Individual
MEREDITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1255 W BASELINE RD, MESA, AZ 85202-5820
(480) 296-0351
Mailing address
1255 W BASELINE RD, MESA, AZ 85202-5820
(480) 296-0351
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-14399
AZ
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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