Provider Demographics
NPI:1053549790
Name:MOYER, FARAH ANDRE (PSYD)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:ANDRE
Last Name:MOYER
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 1:830 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1613
Mailing Address - Country:US
Mailing Address - Phone:215-850-3222
Mailing Address - Fax:484-350-3811
Practice Address - Street 1:2132 S 12TH ST STE 402
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4810
Practice Address - Country:US
Practice Address - Phone:484-602-5775
Practice Address - Fax:484-350-3811
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016643103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist