Individual
MARY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1303 HIXSON PIKE, CHATTANOOGA, TN 37405-3151
(828) 279-5964
Mailing address
3541 DELL TRL, CHATTANOOGA, TN 37411-4410
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6229
TN
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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