Individual
BRIA ADRIANNA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930
Mailing address
192 NORFOLK ST, WEST HAVEN, CT 06516-2559
(203) 606-4338
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
865313-010-0076
AETNA
CT
Enumeration date
08/30/2017
Last updated
08/30/2017
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