MR. Nedward B;aine Moore III, BA

NPI #1508160771 in Portage, Pennsylvania

Provider Information

NPI Number: 1508160771
Entity Type: Individual
Name: MR. Nedward B;aine Moore III, BA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: BA
Enumeration Date: Jan 3, 2011
Last Updated: Jan 3, 2011

Practice Location

Address: 220 PLANE RD
City: Portage
State: Pennsylvania
ZIP Code: 15946-6704
Phone: (814) 736-9700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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