Individual
DR. EMILY DRIVER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2418 MILES RD SE, ALBUQUERQUE, NM 87106-3224
(505) 259-1414
(505) 245-9161
Mailing address
2418 MILES RD SE, ALBUQUERQUE, NM 87106-3224
(505) 259-1414
(505) 245-9161
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
486
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042022
MHN PROVIDER NUMBER 1993
NM
01
—
38363
2000 MHN PROVIDER #
NM
01
—
NM9999
MUTUAL OF OMAHA #
NM
01
—
NMOON985
BLUE CROSS/BLUE SHIELD #
NM
Enumeration date
09/30/2006
Last updated
07/08/2007
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