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NPI Code Detail

MEDICARE: ANNE BERRYMAN MOORE PSYD

MEDICARE: ANNE BERRYMAN MOORE PSYD
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
1103TC0700XClinical Psychologist2785GA

General Provider Information

NPI Number : 1972348258
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE BERRYMAN MOORE PSYD
Provider Business Mailing Address
First Line : 6105 BLUE STONE RD APT 308
Second Line :
City : ATLANTA
State : GA
Zip : 30328-5906
Country : US
Telephone Number : 404-513-3918
Fax Number :
Provider Business Practice Location Address
First Line : 3372 PEACHTREE RD NE STE 115
Second Line :
City : ATLANTA
State : GA
Zip : 30326-1963
Country : US
Telephone Number : 719-666-1785
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2024
Last Update Date : 06/27/2024

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Directions to “ ANNE BERRYMAN MOORE PSYD” Practice Location

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