Individual
HEATHER ELAINE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NC
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
NC
Other
Enumeration date
05/04/2021
Last updated
08/18/2021
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