Individual
ANGELA C MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCMHT
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 213-5888
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7071
MS
Other
Enumeration date
06/17/2026
Last updated
06/17/2026
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