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Octavia Moore
Counselor in Lake Village, Arkansas
NPI 1922369511

Octavia Moore is a Counselor based in Bentonville, AR. Octavia Moore practices in Lake Village, AR. The NPI Number for Octavia Moore is 1922369511 and holds a License No. (Arkansas).

The current practice location address for Octavia Moore is 608 S Highway 65 82 Ste B, Lake Village, AR and can be reached out via phone at 870-265-3711.

Location: 608 S Highway 65 82 Ste B, Lake Village, AR, 72712-4576
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922369511
Provider Name
Octavia Moore
Credential
Provider Entity Type
Individual
Gender
Female
Address
608 S Highway 65 82 Ste B, Lake Village, AR, 72712-4576
Phone Number
870-265-3711
Fax Number
Provider Enumeration Date
05/31/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
608 S Highway 65 82 Ste B
City
Lake Village
State
Arkansas
Zip
71653-1744
Phone Number
870-265-3711
Fax Number
person
Provider Business Mailing Address Details
Address
608 S Highway 65 82 Ste B
City
Lake Village
State
Arkansas
Zip
71653-1744
Phone Number
870-265-3711
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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