Individual
SUE B MOULTRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
123 SAND MOUNTAIN DR NW, ALBERTVILLE, AL 35950-1647
(256) 878-3809
(256) 878-8022
Mailing address
123 SAND MOUNTAIN DR., NW, ALBERTVILLE, AL 35950-0859
(256) 878-3809
(256) 878-8022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1447C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051532527
BCBS
AL
05
—
051551556
—
AL
01
—
631250107003
TRICARE
AL
Enumeration date
08/08/2006
Last updated
09/29/2010
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