Individual
ANDREA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12446 S LOOMIS ST, CALUMET PARK, IL 60827-5832
(773) 641-7095
Mailing address
PO BOX 53529, CHICAGO, IL 60653-0529
(773) 641-7095
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.016158
IL
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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