Individual
JULIA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5031 DEDMAN DR, SHREVEPORT, LA 71107-2821
(318) 518-9197
Mailing address
2620 CENTENARY BLVD, SHREVEPORT, LA 71104-3356
(318) 518-9197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PLC10008
LA
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/11/2016
Last updated
09/06/2024
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