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:
Health care specialties
| Specialty | Code | License # | 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 19 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 | 1962449124 | NPPES |
| North Carolina | MEDICAID | 6107201 | |
| North Carolina | Other | 137PE |
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