Individual
ANNILYCE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7220 W JEFFERSON AVE STE 100, LAKEWOOD, CO 80235-2015
(303) 225-7673
Mailing address
50 21ST AVE APT E2, LONGMONT, CO 80501-1235
(720) 276-3119
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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