| Patricia Diahann Moore, | |
|
133 Cheesman Lake Cir, Divide, CO 80814-9776 | |
| (719) 686-1781 | |
| Not Available |
| Full Name | Patricia Diahann Moore |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 133 Cheesman Lake Cir, Divide, Colorado |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841657244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | NLC0011260 (Colorado) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACB0007760 (Colorado) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia Diahann Moore, Po Box 17613, Colorado Springs, CO 80935-7613 Ph: (719) 686-1781 | Patricia Diahann Moore, 133 Cheesman Lake Cir, Divide, CO 80814-9776 Ph: (719) 686-1781 |
Ms. Jacqueline Revello, MA, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 11115 W. Hwy 24, Unit 2c, Divide, CO 80814 Phone: 719-687-6416 | |
Mrs. Joy Ann Buckley, LPC LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1761 County Road 5, Divide, CO 80814 Phone: 719-200-7209 Fax: 719-687-9668 | |
Barbara Jean Wegener, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 337 Blue Spruce Rd, Divide, CO 80814 Phone: 719-396-4650 Fax: 720-465-2275 |