Individual
IVORY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2059 SCENIC HWY N STE 101, SNELLVILLE, GA 30078-6141
(470) 327-9193
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-203025
GA
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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