Moore Psychotherapy Care LLC
Psychologist, Clinical in Philadelphia, PA. Organization (NPI-2).
NPI number1265856447
StatusActive
Last updated in NPPESFeb 21, 2024
Details
- NPI
- 1265856447
- Entity type
- Organization (NPI-2)
- Legal business name
- Moore Psychotherapy Care LLC
- Organization subpart
- No
- Enumeration date
- Feb 9, 2014
- Certification date
- Feb 21, 2024
- Last updated
- Feb 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PS015627 | PA | Yes |
Practice location
2400 Chestnut St Apt 2810Philadelphia, PA 19103-4325
Phone 267-879-4110
Mailing address
2400 Chestnut St Apt 2810Philadelphia, PA 19103-4325
Phone 267-879-4110
Authorized official
Mark Anthony Moore
Proprietor
2678794110
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