Individual
THOMAS MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
330 S WHITNEY WAY, SUITE 304, MADISON, WI 53705-4638
(608) 231-3191
(608) 231-3108
Mailing address
330 S WHITNEY WAY, SUITE 304, MADISON, WI 53705-4638
(608) 231-3191
(608) 231-3108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1245
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39046900
—
WI
Enumeration date
11/30/2005
Last updated
05/29/2012
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