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General NPI Number Information
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NPI Number | 1164173076
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Entity Type | Organization
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Legal Business Name | MOORE PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 5561 MCNEELY DR STE 202
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City | RALEIGH
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State | NC
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Zip | 27612-7625
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Country | US
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Telephone | 919-870-8151
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Fax | 919-870-5618
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Provider Business Mailing Address
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Address Line | 5561 MCNEELY DR STE 202
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City | RALEIGH
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State | NC
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Zip | 27612-7625
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Country | US
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Telephone | 919-418-2677
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICE ANN MOORE
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Credential | MA, LPA, HSP-PA
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Telephone | 919-418-2677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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