person
Stacey L Moore, LPC
Professional Counselor in Wauwatosa, Wisconsin
NPI 1225210206

Stacey L Moore is a Professional Counselor based in Wauwatosa, WI and is specialized in Professional. Stacey L Moore practices in Wauwatosa, WI and has the professional credentials of LPC. The NPI Number for Stacey L Moore is 1225210206 and holds a License No. 3571 (Wisconsin).

The current practice location address for Stacey L Moore is 1220 Dewey Ave, Wauwatosa, WI and can be reached out via phone at 414-454-6600 and via fax at 414-454-6450. You can also correspond with Stacey L Moore through the mailing address at 1220 DEWEY AVE, WAUWATOSA, WI - 53213-2504 (mailing address contact number: 414-454-6600).

Location: 1220 Dewey Ave, Wauwatosa, WI, 53213-2504
person
Provider Profile Details
NPI Number
1225210206
Provider Name
Stacey L Moore
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
1220 Dewey Ave, Wauwatosa, WI, 53213-2504
Phone Number
414-454-6600
Fax Number
414-454-6450
Provider Enumeration Date
11/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
40995500 05 WI
institution
Provider Business Practice Location Address Details
Address
1220 Dewey Ave
City
State
Zip
53213-2504
Phone Number
414-454-6600
Fax Number
414-454-6450
person
Provider Business Mailing Address Details
Address
1220 Dewey Ave
City
State
Zip
53213-2504
Phone Number
414-454-6600
Fax Number
414-454-6450
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
3571 (Wisconsin)
Definition
Definition to come...
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