Organization
TRACEE N. MOORE, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACEE N MOORE PH.D (LICENSED PSYCHOLOGIST)
(813) 714-7999
Entity
Organization
Contact information
Practice address
1936 BRUCE B DOWNS BLVD, SUITE 75, WESLEY CHAPEL, FL 33544-9262
(678) 939-8150
Mailing address
1936 BRUCE B DOWNS BLVD, SUITE 75, WESLEY CHAPEL, FL 33544-9262
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY8549
FL
103TA0700X
Adult Development & Aging Psychologist
PY8549
FL
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/27/2012
Last updated
05/01/2020
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