Individual
KATHRYN ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 SANDERS DR, AMORY, MS 38821-9167
(662) 542-8388
Mailing address
815 SANDERS DR, AMORY, MS 38821-9167
(662) 542-8388
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-348285
MS
Other
Enumeration date
12/09/2024
Last updated
12/30/2024
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