Individual
DANICA SHAVON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5013 PULASKI AVE, PHILADELPHIA, PA 19144-4111
(215) 518-1049
Mailing address
5013 PULASKI AVE, PHILADELPHIA, PA 19144-4111
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC011534
PA
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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