NPI Profile for JOHN P MOORE in DAYTON, OH.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Social Worker |
104100000X |
| NPI # | 1790146595 |
|
| Status | Active | |
| Credentials | L.M.H.C.,L.S.W.,M.A. | |
| Entity | Individual | |
| Enumeration date | 03/08/2016 | |
| Last updated | 03/08/2016 - About 10 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JOHN P MOORE
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