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Individual

CHRISTINE R. MOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
1414 SW 8TH AVE, TOPEKA, KS 66606-1535
(785) 354-5300
(785) 354-5309
Mailing address
1414 SW 8TH AVE, TOPEKA, KS 66606-1535
(785) 354-5300
(785) 354-5309

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1132
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068002148
MEDICARE PTAN
KS
05
100007790B
KS
Enumeration date
11/16/2011
Last updated
10/31/2016
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