Provider Demographics
NPI:1063719995
Name:MORAN, MICHELE SOLOMON (MS)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:SOLOMON
Last Name:MORAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:MICKLETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08056-1139
Mailing Address - Country:US
Mailing Address - Phone:856-217-4678
Mailing Address - Fax:
Practice Address - Street 1:15 LINDEN ST
Practice Address - Street 2:
Practice Address - City:MICKLETON
Practice Address - State:NJ
Practice Address - Zip Code:08056-1139
Practice Address - Country:US
Practice Address - Phone:856-217-4678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health