Individual
DR. SUSAN LYNN MOSCHOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3501 HEALTH CENTER BLVD STE 2190, ESTERO, FL 34135-8133
(239) 468-0300
(239) 343-4257
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 468-0300
(239) 343-4257
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
4541
NC
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY10528
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116060600
—
FL
Enumeration date
09/15/2015
Last updated
11/08/2022
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