Individual
KEVIN DEANDRE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3048 E BASELINE RD STE 101, MESA, AZ 85204-7287
(520) 231-7380
Mailing address
912 E 10TH ST, MESA, AZ 85203-5632
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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