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Individual

TALASHA D MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CRC, LPC

Contact information

Practice address
555 TOWNER ST, YPSILANTI, MI 48198-5723
(734) 544-3000
(734) 544-6716
Mailing address
5229 W MICHIGAN AVE LOT 326, YPSILANTI, MI 48197-9169
(734) 985-1834

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401019136
MI
225C00000X
Rehabilitation Counselor
137516
MI

Other

Enumeration date
11/17/2017
Last updated
05/01/2022
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