Individual
ANNE A GEPHART MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
1940 NERGE RD, ELK GROVE VILLAGE, IL 60007-2972
(847) 333-7750
Mailing address
1940 NERGE RD, ELK GROVE VILLAGE, IL 60007-2972
(847) 333-7750
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005936
IL
Other
Enumeration date
08/10/2005
Last updated
12/15/2016
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