Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1043648983 |
---|---|
Provider Name | Monica Moment |
First Address | Washington, DC 20002-7953 |
Second Address | Washington, DC 20002-7953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2013 |
Last Update Date | 30/10/2013 |