Individual
ARDELLE MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, LICDC
Contact information
Practice address
16902 LANGLY AVE, CLEVELAND, OH 44128
(216) 849-3390
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 260-8327
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.141295
OH
104100000X
Social Worker
Primary
I.1800801
OH
Other
Enumeration date
02/01/2012
Last updated
06/05/2018
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