Individual
MICHAEL SCOTT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3103 DIXIE HWY, HAMILTON, OH 45015-1653
(513) 892-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 743-7628
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.184050
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/19/2023
Last updated
12/08/2023
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