Individual
AMANDA JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4700 SPRING ST STE 203, LA MESA, CA 91942-0273
(619) 549-0329
Mailing address
PO BOX 2763, SPRING VALLEY, CA 91979-2763
(619) 634-7537
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11201
CA
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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