Individual
AMANDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 WHISPERING WIND DR STE 110, TRACY, CA 95377-8119
(209) 572-2589
(209) 572-1461
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
(209) 572-1461
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
16-23770
CA
Other
Enumeration date
03/12/2018
Last updated
06/05/2020
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