Moore, Marilyn K

Moore, Marilyn K is an individual health care provider with primary practice located at 920 N Citadel Ave , Tucson AZ 85748-2730. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Moore, Marilyn K can be contacted via phone (520) 296-2751.

Contact Information

Primary practice address
920 N Citadel Ave Tucson AZ 85748-2730
Phone: (520) 296-2751
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 1774 Arizona
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1774 Arizona

Profile Details

NPI number 1548327125
LBN Legal business name Moore, Marilyn K
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Jul 20th, 2012 - about 13 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 1548327125 NPPES
Arizona MEDICAID 054742

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