Provider Demographics
NPI:1730324021
Name:MOORE, MEGAN MCCUSKER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MCCUSKER
Last Name:MOORE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EMERSON WAY
Mailing Address - Street 2:
Mailing Address - City:EAST FALLOWFIELD TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4343
Mailing Address - Country:US
Mailing Address - Phone:610-405-1982
Mailing Address - Fax:
Practice Address - Street 1:100 EMERSON WAY
Practice Address - Street 2:
Practice Address - City:EAST FALLOWFIELD TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:19320-4343
Practice Address - Country:US
Practice Address - Phone:610-405-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical