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Individual

DR. MARK MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
230 W WASHINGTON SQ, 2ND FLOOR, PHILADELPHIA, PA 19106-3500
(215) 829-6088
(215) 829-6104
Mailing address
230 W WASHINGTON SQ, 2ND FLOOR, PHILADELPHIA, PA 19106-3500
(215) 829-6088
(215) 829-6104

Taxonomy

Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
PS015627
PA

Other

Enumeration date
04/23/2007
Last updated
07/08/2007
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