Individual
PAGE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR STE 210, COLUMBIA, SC 29203-6859
(803) 935-5604
(803) 434-8606
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
276592
SC
Other
Enumeration date
05/12/2017
Last updated
05/07/2019
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