Individual
MARLOTT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 PLEASANT HILL RD, DULUTH, GA 30096-4159
(770) 330-3848
Mailing address
2500 PLEASANT HILL RD APT 2507, DULUTH, GA 30096-4178
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
20-145197
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092729
PRIVATE
—
Enumeration date
11/12/2021
Last updated
11/12/2021
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