Individual
CANDICE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
1375 CAMILLA DR, GREENVILLE, NC 27834-9556
(252) 258-5243
Mailing address
1375 CAMILLA DR, GREENVILLE, NC 27834-9556
(252) 258-5243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21982
NC
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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