Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 934 | NH |
NPI | 1003146697 |
---|---|
Provider Name | Catherine Eleni Moore |
First Address | Manchester, NH 03102-3770 |
Second Address | Manchester, NH 03102-3770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2010 |
Last Update Date | 22/03/2021 |