Provider Demographics
NPI:1952619900
Name:MORAN, MICHELLE DENISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DENISE
Last Name:MORAN
Suffix:
Gender:F
Credentials:PSYD
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Mailing Address - Street 1:1001 PARK AVE
Mailing Address - Street 2:UNIT 205
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4300
Mailing Address - Country:US
Mailing Address - Phone:626-833-6402
Mailing Address - Fax:
Practice Address - Street 1:8300 S VERMONT AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3493
Practice Address - Country:US
Practice Address - Phone:323-965-6165
Practice Address - Fax:323-789-3363
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2015-06-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor