Mary Moore, MA
Psychologist in Kalamazoo, MI. Individual provider (NPI-1).
NPI number1760683049
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1760683049
- Entity type
- Individual (NPI-1)
- Name
- Mary Moore
- Credential
- MA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 31, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 6301007034 | MI | Yes |
Practice location
200 Turwill LnKalamazoo, MI 49006-4277
Phone 269-344-4413
Mailing address
2115 Broadway AveKalamazoo, MI 49008-1614
Phone 269-344-4413
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