Individual
LISA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2714 TUPELO ST, LAKE CHARLES, LA 70601-7376
(337) 485-9863
Mailing address
2714 TUPELO ST, LAKE CHARLES, LA 70601-7376
(337) 485-9863
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/07/2017
Last updated
08/14/2023
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