Individual
MRS. KELLY ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5323 FAWN CT, OAK FOREST, IL 60452-2200
(312) 771-2346
Mailing address
17845 RIDGELAND AVE, TINLEY PARK, IL 60477-4383
(312) 771-2346
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-12877
—
Other
Enumeration date
12/29/2013
Last updated
07/09/2025
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