Individual
AGNES M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
490 RIDGE RD E, ROCHESTER, NY 14621-1229
(585) 922-2500
(585) 922-2664
Mailing address
PO BOX 10787, ROCHESTER, NY 14610-0787
(585) 922-1122
(585) 922-1985
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
045577
NY
Other
Enumeration date
08/26/2006
Last updated
07/08/2007
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