Individual
KATHERINE MARY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23 ANTHONY RD, FOSTER, RI 02825-1403
(401) 300-1638
Mailing address
23 ANTHONY RD, FOSTER, RI 02825-1403
(401) 300-1638
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW00957
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW00957
LICENSE
RI
Enumeration date
01/25/2023
Last updated
01/25/2023
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