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General NPI Number Information
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NPI Number | 1932692290
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Entity Type | Organization
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Legal Business Name | SKYE MOFFITT PH.D., PLLC
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 10300 N CENTRAL EXPY STE 510
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 214-549-8783
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Fax | 972-392-9695
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Provider Business Mailing Address
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Address Line | 10300 N CENTRAL EXPY STE 510
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 214-549-8783
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Fax | 972-392-9695
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SKYE PORTER MOFFITT
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Credential | PH.D.
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Telephone | 214-549-8783
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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 | 32837
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License Number State | TX
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