Provider Demographics
NPI:1336441856
Name:MOODY, KATHARINE ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:ELIZABETH
Last Name:MOODY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 W LANCASTER AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1592
Mailing Address - Country:US
Mailing Address - Phone:484-802-4833
Mailing Address - Fax:
Practice Address - Street 1:237 W LANCASTER AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1592
Practice Address - Country:US
Practice Address - Phone:484-802-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-04
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor