Doctor Name: | REBECCA ALICE MOORE |
NPI Number: | 1285963348 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | |
Business Practice Address: | 85 Old Eagle School Rd 2nd Floor Strafford, PA - 190872556 |
Business Phone Number: | 6106881636 |
Business Fax Number: | |
Mailing Address: | 109 1/2 N Malin Rd, BROOMALL |
State: | PA |
Postal Code: | 190081535 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/18/2009 |
NPI Last Update Date: | 12/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |