Individual
DR. IAN J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-2152
Mailing address
720 N SPRUCE ST, LITTLE ROCK, AR 72205-3752
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301019281
MI
Other
Enumeration date
10/22/2019
Last updated
01/31/2024
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