Individual
MR. DAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., L.A.C.
Contact information
Practice address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Mailing address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A0011054
AR
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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