Individual
CASEY N MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1118439
IN
Other
Enumeration date
09/15/2011
Last updated
09/22/2025
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