Individual
BREANNA KISHAY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 DAULONG DR, NORTH LITTLE ROCK, AR 72117-3137
(501) 414-6711
Mailing address
2601 DAULONG DR, NORTH LITTLE ROCK, AR 72117-3137
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
944364620
AR
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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