MR. Tavares Moore

NPI #1033627526 in Rockford, Illinois

Provider Information

NPI Number: 1033627526
Entity Type: Individual
Name: MR. Tavares Moore
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jan 18, 2018
Last Updated: Jan 26, 2023

Practice Location

Address: 816 FEATHERSTONE RD
City: Rockford
State: Illinois
ZIP Code: 61107-6300
Phone: (815) 227-0081

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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