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Individual

DR. TIMOTHY RICHARD MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., LP, BCBA-D

Contact information

Practice address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 331-9413
(612) 728-5301
Mailing address
2025 E RIVER RD, MINNEAPOLIS, MN 55414-3604
(612) 624-0722

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5453
MN

Other

Enumeration date
12/22/2011
Last updated
07/10/2025
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