Moore, Blaine
Moore, Blaine is an individual health care provider with primary practice located at 1751 Broad Park Cir S Ste 207 , Mansfield TX 76063-7827. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Moore, Blaine can be contacted via phone (817) 914-2267.Contact Information
Primary practice address
1751 Broad Park Cir S Ste 207
Mansfield TX 76063-7827
Phone: (817) 914-2267
Fax: (817) 225-2144
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 50464 | Texas |
Profile Details
| NPI number | 1346388659 |
|---|---|
| LBN Legal business name | Moore, Blaine |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2007 |
| Last updated | Nov 2nd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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