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General NPI Number Information
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NPI Number | 1528858099
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Entity Type | Individual
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Provider Name | KEVIN MOINO PHD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 8401 MAYLAND DR STE A
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City | RICHMOND
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State | VA
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Zip | 23294-4648
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Country | US
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Telephone | 202-964-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 910 15TH ST NW APT 1001
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City | WASHINGTON
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State | DC
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Zip | 20005-2521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0810008907
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License Number State | VA
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