Individual
MS. ALTHILIA THERESA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
17949 MAIN ST, DUMFRIES, VA 22026-8000
(959) 200-0189
Mailing address
17949 MAIN ST, DUMFRIES, VA 22026-8000
(959) 200-0189
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003562
CT
101YP2500X
Professional Counselor
0701008149
VA
Other
Enumeration date
06/14/2013
Last updated
03/11/2019
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