Individual
GREGORY ALLEN MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 SW GARDEN ST, GRAIN VALLEY, MO 64029-9548
(816) 265-1170
Mailing address
120 SW GARDEN ST, GRAIN VALLEY, MO 64029-9548
(816) 265-1170
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-537418
MO
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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