Individual
DR. LEYONITA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
333 E CAMPUS MALL 7TH FLR, MADISON, WI 53715
(608) 265-5600
Mailing address
PO BOX 7236, MADISON, WI 53707-7236
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
021049-1
NY
103TC1900X
Counseling Psychologist
021049-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021049
LICENSE
NY
01
—
3920
LICENSE
WI
01
—
56974
NATIONAL REGISTER OF HEALTH SERVICE PSYCHOLOGISTS
—
Enumeration date
12/29/2017
Last updated
09/29/2023
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