Blaine Moore, LCSW

NPI #1346388659 in Mansfield, Texas

Provider Information

NPI Number: 1346388659
Entity Type: Individual
Name: Blaine Moore, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Feb 1, 2007
Last Updated: Oct 3, 2024

Practice Location

Address: 601 S MAIN ST
City: Mansfield
State: Texas
ZIP Code: 76063-3112
Phone: (817) 914-2267

Specialties & Taxonomy Codes

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

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