Individual
ASHLEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
75 JOHN ROBERTS RD BLDG B, SOUTH PORTLAND, ME 04106-6967
(617) 501-5301
Mailing address
75 JOHN ROBERTS RD BLDG B, SOUTH PORTLAND, ME 04106-6967
(617) 501-5301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC6957
ME
101YM0800X
Mental Health Counselor
XL518
ME
Other
Enumeration date
06/21/2019
Last updated
04/08/2023
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