Individual
DR. MARY C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
203 S MAIN ST, PROVIDENCE, RI 02903-2992
(401) 273-4942
Mailing address
203 S MAIN ST, PROVIDENCE, RI 02903-2992
(401) 273-4942
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00371
RI
Other
Enumeration date
10/11/2005
Last updated
11/03/2008
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