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Individual

DR. JOANNE G. MOUSSETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
2921 GREENBRIAR DR, SUITE B-1, SPRINGFIELD, IL 62704-6425
(217) 546-3118
(217) 546-3184
Mailing address
2921 GREENBRIAR DR, SUITE B-1, SPRINGFIELD, IL 62704-6425
(217) 546-3118
(217) 546-3184

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
064592
HEALTH ALLIANCE
IL
01
159421 (MHS)
VALUE OPTIONS
IL
01
265199
HEALTH LINK
IL
01
5932532
AETNA
IL
01
L82921
MEDICARE
IL
Enumeration date
05/12/2006
Last updated
07/08/2007
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