Provider Demographics
NPI:1710282058
Name:MOORMAN, ANNORAH SHEERAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNORAH
Middle Name:SHEERAN
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6713 AUDUBON TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3081
Mailing Address - Country:US
Mailing Address - Phone:309-706-2597
Mailing Address - Fax:
Practice Address - Street 1:1208 W MAGNOLIA AVE STE 238
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4472
Practice Address - Country:US
Practice Address - Phone:309-706-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005570103TC0700X
TX39582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical