Provider Demographics
NPI:1689140360
Name:MOOR, CHRISTINA JEANETTE (LCDC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JEANETTE
Last Name:MOOR
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MOOR
Other - Last Name:HOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4518 TUSCARORA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3521
Mailing Address - Country:US
Mailing Address - Phone:832-584-7888
Mailing Address - Fax:
Practice Address - Street 1:7510 FM 1765
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-3672
Practice Address - Country:US
Practice Address - Phone:409-944-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14450101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)