Provider Demographics
NPI:1548650377
Name:MOORE, RHIANNON (PSYD)
Entity type:Individual
Prefix:DR
First Name:RHIANNON
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S CLAIRBORNE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1857
Mailing Address - Country:US
Mailing Address - Phone:913-648-2266
Mailing Address - Fax:913-393-9934
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:STE 104
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1857
Practice Address - Country:US
Practice Address - Phone:913-648-2266
Practice Address - Fax:913-393-9934
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017016787103T00000X
KS2288103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist