Moore, Diana
Moore, Diana is an individual health care provider with primary practice located at 1323 Bia Rd. 20 , Fort Thomspson SD 57339. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Moore, Diana can be contacted via phone (605) 245-1525.Contact Information
Primary practice address
1323 Bia Rd. 20
Fort Thomspson SD 57339
Phone: (605) 245-1525
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2506 | Oregon |
Profile Details
| NPI number | 1902203847 |
|---|---|
| LBN Legal business name | Moore, Diana |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2014 |
| Last updated | Nov 2nd, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902203847 | NPPES |
| South Dakota | MEDICAID | 5549010 |
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