Individual
GRANT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9555 LEBANON RD STE 602, FRISCO, TX 75035-6084
(469) 362-8004
Mailing address
10560 SOLTA DR, DALLAS, TX 75218-1056
(214) 649-9751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
62398
TX
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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