Individual
DR. HOWARD E MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
28175 HAGGERTY RD, NOVI, MI 48377-2903
(248) 994-1154
Mailing address
28175 HAGGERTY RD, NOVI, MI 48377-2903
(248) 994-1154
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301003046
MI
103TC0700X
Clinical Psychologist
Primary
6301003046
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038864
VALUE OPTIONS
MI
01
—
11284079
CAQH
MI
01
—
680F347290
BLUE CROSS PIN
MI
01
—
8672000
MAGELLAN BEHAVIORIAL ID
MI
Enumeration date
10/13/2005
Last updated
10/17/2021
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