Most Relevant Information
Provider Data
| NPI Number: | 1003431594 |
| Provider Name: | LAVONYA ANN MOORE LPCMH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | PC012774 |
Most Important Dates
| Enumeration Date: | 06/10/2020 |
| Last Updated: | 02/08/2024 |
Provider Practice Location
1 CHESTNUT HILL PLZ # 1197
NEWARK
DE
197132761
Practice Location Phone/Fax
| Phone: | 3022056848 |
| Fax: |
Provider Mailing Location
200 CONTINENTAL DR STE 401
NEWARK
DE
197134337
Provider Mailing Phone/Fax
| Phone: | 3022056848 |
| Fax: | 3024170418 |