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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MIRA LUNA FUENTES MOORE

Active Sole Proprietor

MIRA LUNA FUENTES MOORE is a Adult Development & Aging Psychologist healthcare provider located in WYANDOTTE, Michigan. NPI 1265183115 is currently active in the NPPES registry. Verify at CMS.

Adult Development & Aging Psychologist · WYANDOTTE, MI

Registration Details

NPI Number
1265183115
Provider Type
Individual
Gender
Female
NPI Issued
Jan 12, 2022 (4.6137379365309 yrs)
Last Updated
Jan 12, 2022
Sole Proprietor
Yes

Practice Information

Address
1874 4TH ST
WYANDOTTE, MI, 481923905
Browse MI providers · Browse ZIP 48192
Phone
7348289599
Primary Specialty
Adult Development & Aging Psychologist
103TA0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.