Individual
MS. MARY J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
428 CENTENNIAL PKWY, TYLER, TX 75703-7166
(903) 266-5900
Mailing address
428 CENTENNIAL PKWY, TYLER, TX 75703-7166
(903) 266-5900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25651
TX
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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