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Individual

MARLYNN AISHA MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
335 ARCHDALE DR, CHARLOTTE, NC 28217-4212
(888) 392-8642
Mailing address
7427 BALANCING ROCK CT, CHARLOTTE, NC 28262-4236
(704) 804-8763

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
RBT-21-165644
NC

Other

Enumeration date
01/06/2023
Last updated
07/09/2024
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