Provider Demographics
NPI:1992017081
Name:MOYER, KATHERINE H (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:H
Last Name:MOYER
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 1:2117 W WELLSGATE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-6022
Mailing Address - Country:US
Mailing Address - Phone:914-525-6436
Mailing Address - Fax:914-525-6436
Practice Address - Street 1:3405 MIKE PADGETT HWY
Practice Address - Street 2:BUILDING 11
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3815
Practice Address - Country:US
Practice Address - Phone:914-525-6436
Practice Address - Fax:914-525-6436
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003944103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical