Organization
RESILIENT YOUTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA M MOORE (OWNER/SCHOOL PSYCHOLOGIST)
(304) 719-9701
Entity
Organization
Contact information
Practice address
402 CHURCH ST STE 2, SUMMERSVILLE, WV 26651-1495
(304) 719-9701
Mailing address
PO BOX 211, MOUNT NEBO, WV 26679-0211
(304) 719-9701
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
08/15/2023
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