Individual
MRS. MARTINA S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
22639 EUCLID AVE, EUCLID, OH 44117-1622
(216) 404-1900
(216) 404-1901
Mailing address
22639 EUCLID AVE, EUCLID, OH 44117-1622
(216) 404-1900
(216) 404-1901
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
975996
OH
101YP2500X
Professional Counselor
Primary
E.1700264-SUPV
OH
Other
Enumeration date
05/30/2012
Last updated
12/15/2022
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