Individual
KATHY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
2443 LYNN RD STE 112, RALEIGH, NC 27612-6759
(919) 438-4060
Mailing address
2510 CEDAR FOREST WAY APT 103, RALEIGH, NC 27609-2908
(252) 414-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25991
NC
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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