Individual
ANTOINETTE YVONNE MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1712 TERRAPIN HILLS DR, BOWIE, MD 20721-2737
(301) 499-2002
Mailing address
3512 25TH PL, TEMPLE HILLS, MD 20748-2902
(240) 688-7991
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
12958
MD
Other
Enumeration date
07/05/2007
Last updated
03/17/2018
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