Individual
ANN R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
2526 E SUMMER CREEK DR, BLOOMINGTON, IN 47401-8201
(812) 320-3938
Mailing address
2526 E SUMMER CREEK DR, BLOOMINGTON, IN 47401-8201
(812) 320-3938
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041122A
IN
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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