Individual
TRACEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
1227 HWY 77, SUITE 2, MARION, AR 72364
(870) 394-4643
(870) 394-4646
Mailing address
5537 BLEAUX AVE, SPRINGDALE, AR 72762-0737
(479) 872-5580
(479) 872-5581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/02/2008
Last updated
07/07/2011
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