Individual
MS. DEBORAH LYNN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCSW
Contact information
Practice address
1160 COUNTRY CLUB LN, FORT WORTH, TX 76112-2303
(817) 496-9796
Mailing address
1160 COUNTRY CLUB LN, FORT WORTH, TX 76112-2303
(817) 496-9796
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0005000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064289401
—
TX
Enumeration date
07/28/2008
Last updated
07/28/2008
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