Individual
CARLY JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
215 S HURSTBOURNE PKWY STE 213, LOUISVILLE, KY 40222-4937
(502) 353-2074
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
288824
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-23-68942
BCBA CERTIFICATE
—
Enumeration date
03/28/2019
Last updated
11/15/2023
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