Individual
DR. SHANNON MONIQUE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1675 LAKELAND DR STE 304, JACKSON, MS 39216
(769) 524-4578
(769) 524-4630
Mailing address
PO BOX 13563, JACKSON, MS 39236-3563
(769) 524-4578
(769) 524-4630
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
55981
MS
Other
Enumeration date
08/09/2010
Last updated
03/22/2019
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