Individual
DR. LISA MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH. D
Contact information
Practice address
2025 E MAIN ST, SUITE 207C, RICHMOND, VA 23223-7069
(804) 683-8651
(804) 674-4164
Mailing address
4309 SOUNDVIEW LN, CHESTERFIELD, VA 23832-7784
(804) 683-8651
(804) 674-4164
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000002
VA
Other
Enumeration date
09/02/2014
Last updated
09/10/2014
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