Individual
MRS. STEPHANI MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.M., LBA, BCBA
Contact information
Practice address
3680 S CEDAR ST STE A, TACOMA, WA 98409-5728
(253) 289-9500
Mailing address
PO BOX 88083, TUKWILA, WA 98138-2083
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61167965
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111524501
—
WA
Enumeration date
05/17/2017
Last updated
04/24/2023
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