Individual
DR. ELIZABETH L MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 W CENTER ST STE C3, MANCHESTER, CT 06040-4870
(860) 880-1334
Mailing address
200 W CENTER ST STE C3, MANCHESTER, CT 06040-4870
(860) 880-1334
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
002838
CT
103TC0700X
Clinical Psychologist
002838
CT
103TC0700X
Clinical Psychologist
2668
WI
103TC1900X
Counseling Psychologist
Primary
002838
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008028383
—
CT
Enumeration date
03/20/2007
Last updated
03/28/2020
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