Individual
MS. MICHELLE BACON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3450 CHESTNUT ST, 3RD FLOOR, NEW ORLEANS, LA 70115-2443
(504) 412-1580
Mailing address
PO BOX 62243, NEW ORLEANS, LA 70162-2243
(504) 412-1100
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
11/22/2008
Last updated
11/11/2010
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