Individual
ANDREA NICOLE MOULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
Mailing address
1459 CLOVER RD, CAMP HILL, PA 17011-1102
(717) 364-4686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016854
PA
Other
Enumeration date
05/30/2019
Last updated
06/11/2019
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