Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 6301001704 | MI |
NPI | 1003084161 |
---|---|
Provider Name | Dr. Thomas Francis Mooney |
First Address | Port Huron, MI 48060-3860 |
Second Address | Port Huron, MI 48060-3860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2008 |
Last Update Date | 12/02/2008 |