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Contact Information

DIANA MOORE, PHD
1323 BIA RD. 20
FORT THOMSPSON, SD57339
 Phone: 605-245-1525
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DIANA MOORE · (Female)

NPI Number 1902203847
Status Active
Credentials PHD
Entity Individual
Enumeration date 11/20/2014
Last updated 11/02/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 2506
  • SD Medicaid 5549010
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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