Individual
DR. KEITH CORY MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1808 DEL WEBB GARDENS DR, FUQUAY VARINA, NC 27526-3359
(631) 271-8800
Mailing address
1808 DEL WEBB GARDENS DR, FUQUAY VARINA, NC 27526-3359
(631) 271-8800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
8629
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
8629
NY
103TA0700X
Adult Development & Aging Psychologist
8629
NY
103TB0200X
Cognitive & Behavioral Psychologist
8629
NY
103TC0700X
Clinical Psychologist
008629
NY
103TC0700X
Clinical Psychologist
Primary
8629
NY
103TC0700X
Clinical Psychologist
PP6551
NC
103TC0700X
Clinical Psychologist
TPPY2772
FL
103TC1900X
Counseling Psychologist
8629
NY
103TC2200X
Clinical Child & Adolescent Psychologist
8629
NY
103TF0000X
Family Psychologist
8629
NY
103TH0100X
Health Service Psychologist
8629
NY
103TS0200X
School Psychologist
8629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008629
LICENSE
NY
05
—
00972665
—
NY
01
—
PP6551
LICENSE
NC
01
—
TPPY2772
LICENSE
FL
Enumeration date
01/25/2006
Last updated
08/21/2024
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