Individual provider · Type 1 NPI
Carrie Renae Moore, SAC-IT
Addiction (Substance Use Disorder) Counselor · Kenosha, WI
NPI number
1508684804
Active
Practice location
6321 23rd Ave
Kenosha, WI 53143-4805
Fax (866) 719-3024
Mailing address
1826 N Main St
Racine, WI 53402-4711
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 20205-130 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1508684804
Carrie Renae Moore, SAC-IT's National Provider Identifier is 1508684804, issued on Sep 26, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kenosha, WI. The record was last updated on Oct 29, 2024.