Individual
DR. JAMES MARVIN MOORE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
3188 MANSFIELD ST, THE VILLAGES, FL 32162-7448
(352) 409-7030
Mailing address
3188 MANSFIELD ST, THE VILLAGES, FL 32162-7448
(352) 409-7030
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY3671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75793
BC/BS ID NUMER
FL
Enumeration date
09/30/2005
Last updated
07/08/2007
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