Mikayla C Moore
NPI #1104691781 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1104691781
- Entity Type
- Individual
- Name
- Mikayla C Moore
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Nov 23, 2023
- Last Updated
- Nov 23, 2023
Practice Location
- Address
- 330 E BELTLINE AVE NE STE 320
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49506-1267
- Phone
- (616) 745-8640
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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