Individual
ASPEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6371 SEYMOUR PL NW, ACWORTH, GA 30101-8063
(770) 508-0686
Mailing address
6371 SEYMOUR PL NW, ACWORTH, GA 30101-8063
(770) 508-0686
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-10-81966
GA
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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