Organization
MELODIE K MOOREHEAD, PHD, ABPP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELODIE K MOOREHEAD PHD (OWNER)
(954) 444-1445
Entity
Organization
Contact information
Practice address
1201 E BROWARD BLVD, FT LAUDERDALE, FL 33301-2133
(954) 444-1445
Mailing address
1201 E BROWARD BLVD, FT LAUDERDALE, FL 33301-2133
(954) 444-1445
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4324
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75811
BC/BS
FL
Enumeration date
01/29/2008
Last updated
01/29/2008
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