Page Moore
Psychologist, School in Columbia, SC. Individual provider (NPI-1).
NPI number1124555834
StatusActive
Last updated in NPPESMay 7, 2019
Details
- NPI
- 1124555834
- Entity type
- Individual (NPI-1)
- Name
- Page Moore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 12, 2017
- Last updated
- May 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | 276592 | SC | Yes |
Practice location
9 Richland Medical Park Dr Ste 210Columbia, SC 29203-6859
Phone 803-935-5604 · Fax 803-434-8606
Mailing address
Po Box 743904Atlanta, GA 30374-3904
Phone 803-296-7320 · Fax 803-296-7330
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