Lisa J Moore Llc | |
1409 Kingsley Ave Ste 9d Orange Park FL 32073-4580 | |
(904) 571-8701 | |
(904) 571-8701 |
Full Name | Lisa J Moore Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 1409 Kingsley Ave Ste 9d, Orange Park, Florida |
Authorized Official Name and Position | Elisabeth J Tudor (OWNER) |
Authorized Official Contact | 9042692931 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lisa J Moore Llc 1409 Kingsley Ave Ste 9d Orange Park FL 32073-4580 Ph: (904) 571-8701 | Lisa J Moore Llc 1409 Kingsley Ave Ste 9d Orange Park FL 32073-4580 Ph: (904) 571-8701 |
NPI Number | 1093561987 |
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Provider Enumeration Date | 04/30/2024 |
Last Update Date | 04/30/2024 |
Certification Date | 04/30/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093561987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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