Individual
JULIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
836 N DETROIT ST, LAGRANGE, IN 46761-1112
(260) 499-3019
(260) 499-3022
Mailing address
PO BOX 497, WARSAW, IN 46581-0497
(574) 267-7169
(574) 269-4189
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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