Individual
CHEWANDA RENEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
793 GABRIEL LN, NEWPORT NEWS, VA 23608-1118
(757) 286-8071
Mailing address
793 GABRIEL LANE, NEWPORT NEWS, VA 23608
(757) 286-8071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102156
VA
101YP2500X
Professional Counselor
Primary
0701004210
VA
Other
Enumeration date
07/26/2007
Last updated
10/27/2007
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