Individual
LYDA PARKER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
120 W STEPHEN FOSTER AVENUE, SUITE 101, BARDSTOWN, KY 40004-1465
(502) 350-3594
(502) 348-3505
Mailing address
120 W STEPHEN FOSTER AVE, SUITE 101, BARDSTOWN, KY 40004-1465
(502) 350-3594
(502) 348-3505
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
401
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89000020
—
KY
Enumeration date
03/02/2007
Last updated
07/08/2007
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