MEDICARE: DR. JOY R. WILLIAMS-MOORE SCHILLING PH.D.

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
1	103T00000X	Psychologist	1365	CO

General Provider Information

NPI Number	:	1386761849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOY R. WILLIAMS-MOORE SCHILLING PH.D.

Provider Business Mailing Address
First Line	:	1538 W COSTILLA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-4247
Country	:	US
Telephone Number	:	719-634-6737
Fax Number	:	719-362-4402

Provider Business Practice Location Address
First Line	:	2207 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3324
Country	:	US
Telephone Number	:	719-634-6737
Fax Number	:	719-362-4402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	04/11/2013

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