Individual provider · Type 1 NPI
Wendolyn Moon, LCDC
Addiction (Substance Use Disorder) Counselor · Tyler, TX
NPI number
1174324743
Active
Practice location
2323 W Front St
Tyler, TX 75702-7747
Mailing address
1278 FM 1798 E
Mount Enterprise, TX 75681-3091
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 14225 (TX) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1174324743
Wendolyn Moon, LCDC's National Provider Identifier is 1174324743, issued on Mar 20, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tyler, TX. The record was last updated on Mar 20, 2025.