Individual
CORBIN MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 WYATT DR, LAS CRUCES, NM 88005-2925
(575) 652-3155
(575) 652-4104
Mailing address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(575) 652-3155
(575) 652-4104
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
07/15/2019
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