Individual
MS. ANGELA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
208 18TH ST, SUITE 208, ROCK ISLAND, IL 61201-8720
(309) 799-7044
(309) 799-7574
Mailing address
12200 104TH ST, COAL VALLEY, IL 61240-9712
(309) 799-7044
(309) 799-7574
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149-005379
IL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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