Individual
MAYA RENE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1710 ALLEN ST, KELSO, WA 98626-4907
(360) 261-7020
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61368575
WA
Other
Enumeration date
06/27/2021
Last updated
07/12/2023
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