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Individual

MRS. DIANE MARIE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHCA

Contact information

Practice address
11105 NE 14TH ST, SUITE 102, VANCOUVER, WA 98684-4308
(360) 909-8827
Mailing address
11105 NE 14TH ST, SUITE 102, VANCOUVER, WA 98684-4308
(360) 909-8827

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC60330955
WA

Other

Enumeration date
05/15/2013
Last updated
05/15/2013
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