Individual
SHARON MOEHLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED,S.
Contact information
Practice address
266 LAMP AND LANTERN VLG, TOWN AND COUNTRY, MO 63017-8209
(636) 227-4949
(636) 779-1456
Mailing address
266 LAMP AND LANTERN VLG, TOWN AND COUNTRY, MO 63017-8209
(636) 227-4949
(636) 779-1456
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0178
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003974
REGENCE
ID
01
—
481086633
TAX IDENTIFICATON
ID
05
—
805997100
—
ID
01
—
X5960
BLUE CROSS
ID
Enumeration date
04/12/2007
Last updated
07/30/2008
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