Individual
BRENDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHC, CASAC, FDLC
Contact information
Practice address
89-30 161T STREET, SCO CHILDREN AND FAMILY SERVICES, JAMAICA, NY 11432
(718) 674-7773
Mailing address
19608 99TH AVE, HOLLIS, NY 11423-3301
(347) 489-3434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26645
NY
Other
Enumeration date
11/04/2015
Last updated
06/21/2021
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