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Individual

KENNEDY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCABA

Contact information

Practice address
905 W GLEN PARK AVE, GRIFFITH, IN 46319-2028
(219) 501-1729
Mailing address
905 W GLEN PARK AVE, GRIFFITH, IN 46319-2028
(219) 501-1729

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
01/14/2025
Last updated
09/02/2025
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