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Individual

KEVIN LONNELL MOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5905 NASSAU ST, DISTRICT HEIGHTS, MD 20747-1218
(227) 225-7800
Mailing address
5905 NASSAU ST, DISTRICT HEIGHTS, MD 20747-1218
(227) 225-7800

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
MD
3747P1801X
Personal Care Attendant
Primary
MD

Other

Enumeration date
04/23/2026
Last updated
04/29/2026
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