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Individual

JAMES R MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
12807 ROSSMERE CT, MIDLOTHIAN, VA 23114-3093
(800) 632-6074
Mailing address
7431 114TH AVE, SUITE 104, LARGO, FL 33773-5119

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002661
VA

Other

Enumeration date
07/15/2009
Last updated
02/24/2010
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