Individual
DR. NANCY JOAN MOONSTARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD & LPC
Contact information
Practice address
4 RIVERVIEW RD, SEVERNA PARK, MD 21146-4630
(410) 431-8870
(410) 431-7177
Mailing address
4 RIVERVIEW RD, SEVERNA PARK, MD 21146-4630
(410) 431-8870
(410) 431-7177
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LC0408
MD
103T00000X
Psychologist
Primary
PSY1000166
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188103500
—
MD
01
—
LC0408
LCPC
MD
01
—
PSY1000166
PSYCHOLOGIST LICENSE
DC
Enumeration date
11/21/2006
Last updated
12/22/2008
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