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Individual

KELLYN DESIREE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
1101 W MOANA LN, SUITE 2, RENO, NV 89509-4775
(775) 337-2394
(775) 337-9570
Mailing address
3680 MEEKS WAY, RENO, NV 89503-1962
(775) 815-8545

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103K00000X
Behavior Analyst

Other

Enumeration date
02/16/2012
Last updated
03/21/2012
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