Individual
AZJAH DT MOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Mailing address
PO BOX 1306, CONCORD, NC 28026-1306
(843) 934-7593
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
06/15/2021
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