Individual
MR. JOHN PARKER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.H.C.,L.S.W.,M.A.
Contact information
Practice address
1770 SHILOH SPRINGS RD., DAYTON, OH 45426
(937) 367-6300
Mailing address
1770 SHILOH SPRINGS RD, DAYTON, OH 45426
(937) 367-6300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
39001063A
IN
101YM0800X
Mental Health Counselor
Primary
39001063A
IN
104100000X
Social Worker
33002117A
IN
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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