Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | LC8667 | MD |
NPI | 1003301342 |
---|---|
Provider Name | Daniel Anthony Moore |
First Address | Silver Spring, MD 20901-1826 |
Second Address | Upper Marlboro, MD 20772-8088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2018 |
Last Update Date | 28/06/2018 |