Individual
BRIAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1382 S 3RD ST, LOUISVILLE, KY 40208-2351
(502) 637-4361
(502) 637-4490
Mailing address
1382 S 3RD ST, LOUISVILLE, KY 40208-2351
(502) 637-4361
(502) 637-4490
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0939
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4324
—
KY
Enumeration date
05/17/2007
Last updated
11/13/2013
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