Provider Demographics
NPI:1861557654
Name:MORIARTY, KAY RACHEL (EDD)
Entity type:Individual
Prefix:DR
First Name:KAY
Middle Name:RACHEL
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 W DRAKE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2882
Mailing Address - Country:US
Mailing Address - Phone:970-495-4854
Mailing Address - Fax:970-204-7881
Practice Address - Street 1:363 W DRAKE RD STE 2
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2882
Practice Address - Country:US
Practice Address - Phone:970-495-4854
Practice Address - Fax:970-204-7881
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0001189103TC0700X
CO1189103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical