Individual
AMANDA L MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1300 W LANCASTER AVE, FORT WORTH, TX 76102-3499
(682) 303-9200
(682) 303-9239
Mailing address
1300 W LANCASTER AVE, FORT WORTH, TX 76102-3499
(682) 303-9200
(682) 303-9239
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
38514
TX
Other
Enumeration date
06/05/2018
Last updated
12/20/2022
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