Individual
SHEA BRADLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
1 VANTAGE WAY STE E130, NASHVILLE, TN 37228-1591
(615) 669-0179
Mailing address
119 JUPITER DR, ASHLAND CITY, TN 37015-4904
(615) 440-7116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7049
TN
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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