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Organization
PEDIATRIC & FAMILY PSYCHOLOGY CENTER PA
Active
Organization
PEDIATRIC & FAMILY PSYCHOLOGY CENTER PA
Active
Other names
CH Moore PhD dba Pediatric & Family Psychology Center PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. C L MOORE PHD (OWNER)
(651) 771-4766
Entity
Organization
Contact information
Practice address
2440 N CHARLES STREET, SUITE 236, NORTH SAINT PAUL, MN 55109-3050
(651) 771-4766
(651) 771-4784
Mailing address
2440 N CHARLES STREET, SUITE 236, NORTH SAINT PAUL, MN 55109-3050
(651) 771-4766
(651) 771-4784
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
440
CO
103T00000X
Psychologist
LP2246
MN
103T00000X
Psychologist
PY00000625
WA
106H00000X
Marriage & Family Therapist
Primary
1
MN
Other
Enumeration date
07/28/2005
Last updated
09/11/2025
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