Individual
MS. AUDREY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9422 COPPERWAY, CONVERSE, TX 78109-2063
(210) 322-0191
Mailing address
9422 COPPERWAY, CONVERSE, TX 78109-2063
(210) 322-0191
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1099816
TX
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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