Individual
SASHA LADON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1606 BROAD ST, PHENIX CITY, AL 36867-5081
(334) 480-8880
Mailing address
1606 BROAD ST, PHENIX CITY, AL 36867-5081
(334) 480-8888
(855) 330-3337
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4827G
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4827G
ALABAMA LMSW
AL
Enumeration date
07/27/2020
Last updated
07/27/2020
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