Individual
MICHAEL DAVID MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, NCC
Contact information
Practice address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
Mailing address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39004083A
IN
Other
Enumeration date
08/19/2019
Last updated
02/10/2022
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