Individual provider · Type 1 NPI

Tanzania Mala Moore

Mental Health Counselor · Vicksburg, MS

NPI number 1447745567 Active

Practice location

3530 Manor Dr Ste 5A
Vicksburg, MS 39180-5625

Call (601) 738-5260 Map

Fax (601) 738-5361

Mailing address

234 Baugh St
Pearl, MS 39208-4103

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1447745567

Tanzania Mala Moore's National Provider Identifier is 1447745567, issued on Jun 30, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Vicksburg, MS. The record was last updated on Jun 30, 2018.