Individual
KYLA KENYETTA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCI, CAC-P
Contact information
Practice address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
Mailing address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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