STEPHANIE MOORE, MA, CADC, CTP TAMA, IA

Contact Information

STEPHANIE MOORE, MA, CADC, CTP

1646 305TH ST.
TAMA, IA 52339

Phone: 641-484-9482
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Addiction (Substance Use Disorder)	101YA0400X

Indicates primary specialty

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NPI Profile & details for STEPHANIE MOORE · (Female)

NPI Number	`1912543497`
Status	Active
Credentials	MA, CADC, CTP
Entity	Individual
Enumeration date	11/20/2019
Last updated	02/02/2022 - About 4 years ago
Sole proprietor ¹	No
Identifiers	IA License # 19016 IA Medicaid 0074575
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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