Individual
CHANCEY MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1831 N CRYSTAL LAKE DR, LAKELAND, FL 33801-5902
(863) 519-0575
(863) 582-9251
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 582-9251
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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