Individual
DIANA LYNNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7415 GRANDVIEW ST, SHAWNEE MISSION, KS 66204-1796
(913) 676-2253
Mailing address
12509 W 52ND TER, SHAWNEE, KS 66216-1459
(913) 206-3909
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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