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Lateasa Moore, LLMSW
NPI 1982934147 · on the registry since 2010
Practice
- Address
- 1939 Division Ave S
Grand Rapids, MI 49507 - Phone
- (616) 247-3815
- Fax
- (616) 245-0450
- Organisation at this address
- Family Outreach Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 120
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2010-01-11
- Status
- Not present in the most recent federal file
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan