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Individual

ANTIONETTE C MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
5715 UTAH TRL, TWENTYNINE PALMS, CA 92277-6917
(760) 367-0730
(760) 367-0728
Mailing address
PO BOX 1209, TWENTYNINE PALMS, CA 92277-0980
(760) 367-0730

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
79025
CA

Other

Enumeration date
10/07/2014
Last updated
10/18/2018
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