Individual
AUDREY ELAINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
702 W HILLSIDE AVE, PRESCOTT, AZ 86301-1913
(855) 746-3633
Mailing address
5700 MARKET ST APT 2086, PRESCOTT VALLEY, AZ 86314-6517
(208) 505-8933
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
22964
AZ
Other
Enumeration date
08/07/2023
Last updated
10/16/2024
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