Individual
DR. MATT ALAN MOORADIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
9245 CALUMET AVE, SUITE 102, MUNSTER, IN 46321-2821
(219) 836-3101
(219) 836-3102
Mailing address
3513 42ND ST, HIGHLAND, IN 46322-3126
(219) 836-3101
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071-004894
IL
103TC0700X
Clinical Psychologist
Primary
20040803A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019650A
—
IN
01
—
9927419
BCBS
IL
Enumeration date
08/19/2006
Last updated
03/17/2009
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