Individual
KATHLEEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
725 S ADAMS RD, SUITE 222, BIRMINGHAM, MI 48009-6902
(248) 540-7007
Mailing address
725 S ADAMS RD, SUITE 222, BIRMINGHAM, MI 48009-6902
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006114
MI
Other
Enumeration date
06/02/2006
Last updated
05/26/2023
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