| Marcia S. Moore, Ph.d., Plc | |
|
4140 W Memorial Rd Ste. 221 Oklahoma City OK 73120-8366 | |
| (405) 755-5801 | |
| (405) 755-5949 |
| Full Name | Marcia S. Moore, Ph.d., Plc |
|---|---|
| Speciality | Psychologist |
| Location | 4140 W Memorial Rd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Marcia S. Moore (PSYCHOLOGIST) |
| Authorized Official Contact | 4057555801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcia S. Moore, Ph.d., Plc 4140 W Memorial Rd Ste. 221 Oklahoma City OK 73120-8366 Ph: (405) 755-5801 | Marcia S. Moore, Ph.d., Plc 4140 W Memorial Rd Ste. 221 Oklahoma City OK 73120-8366 Ph: (405) 755-5801 |
| NPI Number | 1811214190 |
|---|---|
| Provider Enumeration Date | 04/27/2010 |
| Last Update Date | 04/27/2010 |
| Medicare PECOS PAC ID | 6800910910 |
|---|---|
| Medicare Enrollment ID | O20100826000311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811214190 | NPI | - | NPPES |
| 1194739102 | Other | OK | NPI INDIVIDUAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 415 (Oklahoma) | Primary |
| Provider Name | Marcia S Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194739102 PECOS PAC ID: 2062536170 Enrollment ID: I20100826000336 |
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