Individual
JENNIFER NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11709 COPPER AVE NE, ALBUQUERQUE, NM 87123-1310
(505) 301-9601
Mailing address
11709 COPPER AVE NE, ALBUQUERQUE, NM 87123-1310
(505) 301-9601
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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