| Moore Therapy & Wellness Llc | |
|
1622 7th St Las Vegas NM 87701-4920 | |
| (505) 652-5386 | |
| Not Available |
| Full Name | Moore Therapy & Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 1622 7th St, Las Vegas, New Mexico |
| Authorized Official Name and Position | Kelli Moore (OWNER) |
| Authorized Official Contact | 5056525386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Therapy & Wellness Llc 1622 7th St Las Vegas NM 87701-4920 Ph: () - | Moore Therapy & Wellness Llc 1622 7th St Las Vegas NM 87701-4920 Ph: (505) 652-5386 |
| NPI Number | 1114609849 |
|---|---|
| Provider Enumeration Date | 08/02/2023 |
| Last Update Date | 08/02/2023 |
| Certification Date | 08/02/2023 |
| Medicare PECOS PAC ID | 0941732531 |
|---|---|
| Medicare Enrollment ID | O20241021003637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114609849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelli Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770195380 PECOS PAC ID: 3476085069 Enrollment ID: I20241021003919 |
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