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Individual
MICHAEL SCOTT MOORE
Active
Individual
MICHAEL SCOTT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.184050
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/19/2023
Last updated
12/08/2023
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