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Individual

GREGORY P MOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
180 ACADEMY ST STE 2, PRESQUE ISLE, ME 04769-3183
(207) 764-3319
(207) 768-5377
Mailing address
180 ACADEMY ST STE 3, PRESQUE ISLE, ME 04769-3183
(207) 554-2352
(207) 554-2351

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
CAC6402
ME
101Y00000X
Counselor
Primary
LC7576
ME

Other

Enumeration date
05/24/2019
Last updated
05/27/2021
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