Individual
DR. CHRISTOPHER MOYLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
200 PATEWOOD DR STE A22, GREENVILLE, SC 29615-3593
(864) 454-5115
(864) 454-5111
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1645
SC
103TC0700X
Clinical Psychologist
PSY.1645
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0708
—
SC
01
—
Q70167
MEDICARE
SC
Enumeration date
10/16/2020
Last updated
06/04/2021
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