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Individual

CRYSTAL MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3294 GA-5, DOUGLASVILLE, GA 30135
(888) 329-4535
Mailing address
3421 W STEWARTS MILL RD APT 2O, DOUGLASVILLE, GA 30135-2478
(770) 882-5569

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
GA

Other

Enumeration date
12/10/2021
Last updated
12/10/2021
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