Search › West Virginia › 103T00000X
Myra Moore
NPI 1154673184 · on the registry since 2012
Practice
- Address
- 402 Church St Ste 2
Summersville, WV 26651 - Phone
- (304) 256-4555
- Fax
- (304) 256-4715
- Organisation at this address
- Resilient Youth, Pllc
Inferred from a shared address, not stated in the registry.
Additional practice sites
- 111 Fayette Ave, Fayetteville, WV
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Also registered as
- 103TS0200X
- Licence states on file
- WV
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-08-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in West Virginia