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DR. MARY E MOORE PHD

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1871799957

Individual Registrant:
DR. MARY E MOORE PHD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
325 W HOSPITALITY LANE SUITE 310 SAN BERNANDINO, CA 92408-3212 US
Tel: 909-386-5500  Fax: 909-386-5520

Contact information for business:
325 W HOSPITALITY LANE SUITE 310 SAN BERNANDINO, CA 92408-3212 US
Tel: 909-386-5500  Fax: 909-386-5520

Registration Information:
NPI: 1871799957
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
CAPSY10159

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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