Individual
MRS. M SUSAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2200 FORT ROOTS DR # 116/NLR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3147
(501) 257-3182
Mailing address
2200 FORT ROOTS DR # 116/NLR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3147
(501) 257-3182
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-649
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2084P0800X
PSYCHIATRY
AR
Enumeration date
08/30/2006
Last updated
07/08/2007
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