Individual
KAYLA D MOORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
1330 PAGE DR S STE 102A, FARGO, ND 58103-3562
(701) 478-6604
Mailing address
1204 12TH ST S, MOORHEAD, MN 56560-3708
(601) 580-5453
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
2949
OR
103TC1900X
Counseling Psychologist
Primary
564
ND
103TH0100X
Health Service Psychologist
2949
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1476477
—
ND
Enumeration date
03/30/2018
Last updated
04/11/2019
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