Individual
PHOEBE S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-3220
(508) 856-3036
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3052
NC
103TC0700X
Clinical Psychologist
Primary
9261
MA
103TC0700X
Clinical Psychologist
PSY21384
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110092081A
—
MA
Enumeration date
12/19/2006
Last updated
04/18/2017
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