Individual
MARISA L MOULTRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4664 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 487-7805
(614) 487-7809
Mailing address
2186 E MAIN STREET B304, COLUMBUS, OH 43209
(614) 425-2293
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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