Individual
MRS. SALLY JO GRENARD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2901 BEE CAVES ROAD, BOX N, AUSTIN, TX 78746-5571
(512) 329-8000
(512) 329-8299
Mailing address
10605 SKYFLOWER DRIVE, AUSTIN, TX 78759-6453
(512) 250-5974
(512) 329-8299
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23614
TX
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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