Individual
GRACE KATHLEEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, NCC
Contact information
Practice address
339 BROADWAY ST STE 102, CAPE GIRARDEAU, MO 63701-7321
(573) 271-2008
Mailing address
1112 BERTLING ST APT 221, CAPE GIRARDEAU, MO 63701-3072
(314) 497-0918
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MO
Other
Enumeration date
08/18/2023
Last updated
08/23/2023
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