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Individual

HEATHER RHEA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CADCIII

Contact information

Practice address
1224 N MODOC AVE UNIT 47, MEDFORD, OR 97504-3696
(970) 373-8276
Mailing address
1224 N MODOC AVE UNIT 47, MEDFORD, OR 97504-3696
(970) 373-8276

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PROFESSIONALLICENSE
1041C0700X
Clinical Social Worker
Primary
L14195
OR

Other

Enumeration date
01/14/2010
Last updated
01/09/2024
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