Tina Moulton

NPI #1154697670 in Waukegan, Illinois

Provider Information

NPI Number: 1154697670
Entity Type: Individual
Name: Tina Moulton
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Mar 29, 2012
Last Updated: Mar 29, 2012

Practice Location

Address: 3002 GRAND AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-2321
Phone: (847) 377-8088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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