Individual
DR. ANISSA L MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
703 BLUE SPRING RD, PRINCETON, NJ 08540-1636
(646) 546-0835
Mailing address
905 HERRONTOWN RD, PRINCETON, NJ 08540-1901
(646) 546-0835
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
TP# 093-997
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TP# 093-997
LICENSE NUMBER
NJ
Enumeration date
08/14/2009
Last updated
10/07/2009
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