Individual
DR. EDWARD TINDAL MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
255 S 17TH ST, SUITE 2301, PHILADELPHIA, PA 19103-6231
(610) 659-0774
Mailing address
255 S 17TH ST, SUITE 2301, PHILADELPHIA, PA 19103-6231
(610) 659-0774
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS007695L
PA
Other
Enumeration date
08/04/2006
Last updated
12/06/2016
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