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Individual

DR. JOHN THOMAS MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
498 NW 18TH ST, RICHMOND, IN 47374-2851
(765) 935-9317
Mailing address
507 RUBYTHROAT LN, CLAYTON, OH 45315-8742
(937) 832-0572

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010430A
IN
103TC0700X
Clinical Psychologist
5174
OH

Other

Enumeration date
03/22/2007
Last updated
07/08/2007
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