Individual
TADEKA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49 OLD NORWICH RD, QUAKER HILL, CT 06375-1639
(888) 754-0398
Mailing address
113 SALEM TPKE STE 200, NORWICH, CT 06360-6484
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189574274
—
CT
Enumeration date
11/06/2023
Last updated
11/06/2023
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