Individual
ELISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 CHARMANT PL STE 1, RIDGELAND, MS 39157-4358
(601) 707-5550
Mailing address
199 CHARMANT PL STE 1, RIDGELAND, MS 39157-4358
(601) 707-5550
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P-0927
MS
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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