Individual
CAROL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
916 COX RD STE 201, GASTONIA, NC 28054-3496
(704) 780-4271
(888) 261-6694
Mailing address
1611 E HUDSON BLVD, GASTONIA, NC 28054-1646
(704) 860-6367
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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