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Individual

ELLYSSYA B MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
5837 N DALE ST, JACKSON, MS 39211-3333
(601) 376-6670
Mailing address
5837 N DALE ST, JACKSON, MS 39211-3333
(601) 376-6670

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MS

Other

Enumeration date
09/08/2025
Last updated
09/08/2025
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