Individual provider · Type 1 NPI
Thomas Ian Moore
Mental Health Counselor · San Diego, CA
NPI number
1679934608
Active
Practice location
3132 Jefferson St
San Diego, CA 92110-4421
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | ASW70618 (CA) |
| Counselor | 101Y00000X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1679934608
Thomas Ian Moore's National Provider Identifier is 1679934608, issued on Mar 18, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Diego, CA. The record was last updated on Oct 25, 2017.