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Individual

MRS. SAMANTHA PENA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED., BCBA, LBA

Contact information

Practice address
3446 POST ROAD, WARWICK, RI 02886
(401) 739-2700
Mailing address
3445 POST RD, WARWICK, RI 02886-7147
(401) 304-7878

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA00136
RI

Other

Enumeration date
09/06/2018
Last updated
09/06/2018
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