Maya Rene Moore, LICSW
NPI #1881264406 in Kelso, Washington
Provider Information
- NPI Number
- 1881264406
- Entity Type
- Individual
- Name
- Maya Rene Moore, LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Jun 27, 2021
- Last Updated
- Jul 12, 2023
Practice Location
- Address
- 1710 ALLEN ST
- City
- Kelso
- State
- Washington
- ZIP Code
- 98626-4907
- Phone
- (360) 261-7020
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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