Individual
MATTHEW WILLIAM MOSCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-5160
(214) 648-5195
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-5160
(214) 648-5195
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
36197
TX
103T00000X
Psychologist
36197
TX
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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