Dr. Shannon Monique Moore, PhD
Psychologist, Clinical in Jackson, MS. Individual provider (NPI-1).
NPI number1154636611
StatusActive
Last updated in NPPESMar 22, 2019
Details
- NPI
- 1154636611
- Entity type
- Individual (NPI-1)
- Name
- Dr. Shannon Monique Moore
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 9, 2010
- Last updated
- Mar 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 55981 | MS | Yes |
Practice location
1675 Lakeland Dr Ste 304Jackson, MS 39216
Phone 769-524-4578 · Fax 769-524-4630
Mailing address
Po Box 13563Jackson, MS 39236-3563
Phone 769-524-4578 · Fax 769-524-4630
Other practice locations
1818 Albion St Ste 114
Nashville, TN 37208-2918
Nashville, TN 37208-2918
Phone 615-327-4751
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