Nicole E. Moore | Stafford, TX • PECOS Search

Nicole E. Moore

Counselor

Behavioral Health & Social Service Providers

12307 Elk Meadow Dr, Stafford, TX 77477-2297

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole E. Moore does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 4:18 PM.

Profile Details

Provider ID
1659826766
Provider Type
Individual
Full Name
Moore, Nicole E.
Title
Mrs.
Credential
M.ED, LPC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/18/2016
Last Updated
8/18/2016

Contact Information

Practice Location

12307 Elk Meadow Dr, Stafford, TX 77477-2297

Unlisted Fax

Mailing Location

12307 Elk Meadow Dr, Stafford, TX 77477-2297

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 71865 Texas