Individual
AMY M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9607 MERTON AVE, OAK LAWN, IL 60453-2726
(708) 935-0328
Mailing address
9607 MERTON AVE, OAK LAWN, IL 60453-2726
(708) 935-0328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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