Individual
KIMBERLY ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 LAS VEGAS BLVD N, LAS VEGAS, NV 89101-1115
(702) 369-4357
Mailing address
1417 LAS VEGAS BLVD N, LAS VEGAS, NV 89101-1115
(702) 369-4357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01002
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437594074
—
NV
Enumeration date
11/30/2010
Last updated
07/30/2015
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