Individual
DEVON MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1530 S 18TH ST, LAFAYETTE, IN 47905-2010
(765) 418-6850
(765) 477-7806
Mailing address
1530 S 18TH ST, LAFAYETTE, IN 47905-2010
(765) 418-6850
(765) 477-7806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33005691A
IN
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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