Individual
DEBORAH PRYOR-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1350 BELMONT ST, SUITE 107, BROCKTON, MA 02301-4430
(508) 584-9161
Mailing address
1350 BELMONT ST, SUITE 107, BROCKTON, MA 02301-4430
(508) 584-9161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106803
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000PO4296
BC/BS PROVIDER NUMBER
MA
Enumeration date
09/14/2006
Last updated
07/08/2007
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