Individual
PHAEDRA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
725 ALBANY ST, BOSTON, MA 02118-3549
(617) 414-2283
Mailing address
48 CRESCENT STREET, FIRST FLOOR, WAKEFIELD, MA 01880
(617) 414-2283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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