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NPI Code Detail

MEDICARE: ROBIN MOORE LMLP-T

MEDICARE: ROBIN MOORE LMLP-T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist03299KS

General Provider Information

NPI Number : 1417702986
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN MOORE LMLP-T
Provider Business Mailing Address
First Line : 7321 E 35TH ST N
Second Line :
City : WICHITA
State : KS
Zip : 67226-3803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 S MAIN ST STE 505
Second Line :
City : WICHITA
State : KS
Zip : 67202-3738
Country : US
Telephone Number : 316-688-8390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2024
Last Update Date : 04/18/2024

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Directions to “ ROBIN MOORE LMLP-T” Practice Location

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