Individual
SUSAN A MOORE-MOTILY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3939 W RIDGE RD, STE A210, ERIE, PA 16506-1879
(814) 838-9155
(814) 838-9097
Mailing address
4124 RIDGEWOOD DR, ERIE, PA 16506-4090
(814) 838-9155
(814) 838-9097
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS006812L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211426
VALUE OPTIONS
PA
01
—
500985
KEYSTONE HEALTH PLAN WEST
PA
01
—
5732205
AETNA
PA
01
—
802324
HIGHMARK BC/BS PREMIER BL
PA
Enumeration date
12/06/2005
Last updated
07/08/2007
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