Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 33866 | TX |
Y | 101YS0200X | School Counselor | 33866 | TX |
N | 103TM1800X | Intellectual & Developmental Disabilities | 33866 | TX |
NPI | 1184065773 |
---|---|
Provider Name | Lorenzo Moore |
First Address | Houston, TX 77041-5917 |
Second Address | Houston, TX 77041-5917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2013 |
Last Update Date | 11/07/2013 |