Dr. John Thomas Moore, Ph.D.
Psychologist, Clinical in Richmond, IN. Individual provider (NPI-1).
NPI number1679699151
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1679699151
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Thomas Moore
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 20010430A | IN | Yes |
| 103TC0700X | Psychologist, Clinical | 5174 | OH |
Practice location
498 Nw 18th StRichmond, IN 47374-2851
Phone 765-935-9317
Mailing address
507 Rubythroat LnClayton, OH 45315-8742
Phone 937-832-0572
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