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Individual

DR. ELISABETH ANNE MOUGHTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
7000 E GENESEE ST BLDG B, FAYETTEVILLE, NY 13066-1131
(315) 391-8500
Mailing address
7000 E GENESEE ST BLDG B, FAYETTEVILLE, NY 13066-1131
(315) 391-8500

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
017936-1
NY
103TA0700X
Adult Development & Aging Psychologist
017936-1
NY
103TH0004X
Health Psychologist
017936-1
NY
103TP2701X
Group Psychotherapy Psychologist
017936-1
NY

Other

Enumeration date
04/27/2009
Last updated
04/09/2026
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