Moon, Gloria Dianne

Moon, Gloria Dianne is an individual health care provider with primary practice located at 380 Copperfield Blvd Ne Ne Psychiatric & Psychological Inst, Concord NC 28025-2402. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Moon, Gloria Dianne can be contacted via phone (704) 262-1800.

Contact Information

Primary practice address
380 Copperfield Blvd Ne Ne Psychiatric & Psychological Inst Concord NC 28025-2402
Phone: (704) 262-1800
Fax: (704) 262-1836
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2089 North Carolina

Profile Details

NPI number 1962449124
LBN Legal business name Moon, Gloria Dianne
Credentials LPA
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962449124 NPPES
North Carolina MEDICAID 6107201
North Carolina Other 137PE

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