Basic Information
| Provider Information | |||||||||
| NPI: | 1548650377 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOORE | ||||||||
| FirstName: | RHIANNON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 407 S CLAIRBORNE RD | ||||||||
| Address2: | STE 104 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136482266 | ||||||||
| FaxNumber: | 9133939934 | ||||||||
| Practice Location | |||||||||
| Address1: | 407 S CLAIRBORNE RD | ||||||||
| Address2: | STE 104 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136482266 | ||||||||
| FaxNumber: | 9133939934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2015 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 2017016787 | MO | N | Behavioral Health & Social Service Providers | Psychologist | 103T00000X | 2288 | KS | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.