Individual
NICHOLAS R MOOREHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2630 CENTRAL AVE # 3349, EIELSON AFB, AK 99702-2301
(907) 377-3071
Mailing address
2630 CENTRAL AVE # 3349, EIELSON AFB, AK 99702-2301
(907) 377-3071
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008333
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/15/2022
Last updated
10/23/2023
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