Individual
TIFFINY JEAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
297 N MAIN ST STE 3, BARRE, VT 05641-4503
(802) 793-9144
Mailing address
PO BOX 853, BARRE, VT 05641-0853
(802) 793-9144
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0057639
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018762
—
VT
Enumeration date
02/17/2011
Last updated
05/07/2020
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