Individual
JACQUELINE MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 W 4TH ST, GILLETTE, WY 82716-3330
(888) 924-2366
Mailing address
1562 NW 1ST ST APT 2, BEND, OR 97703-1863
(954) 298-0489
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-55268
OR
Other
Enumeration date
07/30/2019
Last updated
08/15/2024
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