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General NPI Number Information
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NPI Number | 1427350800
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Entity Type | Organization
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Legal Business Name | H SUZANNE MOON, PHD, PC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 210 WINTER ST SUITE 105
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City | WEYMOUTH
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State | MA
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Zip | 02188-3302
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Country | US
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Telephone | 781-812-2294
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Fax | 781-812-2295
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Provider Business Mailing Address
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Address Line | 93 VILLAGE DR
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City | QUINCY
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State | MA
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Zip | 02169-0946
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Country | US
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Telephone | 781-812-2294
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Fax | 781-812-2295
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. H SUZANNE MOON
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Credential | PHD
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Telephone | 781-812-2294
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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 | 7771
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License Number State | MA
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