Provider Demographics
NPI:1760103519
Name:MOORE, HAILEY (MS, LMFT-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:MS, LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6437 YARMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-5037
Mailing Address - Country:US
Mailing Address - Phone:801-502-3591
Mailing Address - Fax:
Practice Address - Street 1:6437 YARMOUTH AVE
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-5037
Practice Address - Country:US
Practice Address - Phone:801-502-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty