Individual
MRS. ANISSA NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
9822 COCHEM PATH, HELOTES, TX 78023-4615
(210) 823-4780
Mailing address
9822 COCHEM PATH, HELOTES, TX 78023-4615
(210) 823-4780
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-07-3621
TX
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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