Individual
MARY ABIGAIL MOLDOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6657 FRANK AVE NW STE 100, NORTH CANTON, OH 44720-8438
(330) 309-3133
Mailing address
6657 FRANK AVE NW STE 100, NORTH CANTON, OH 44720-8438
(330) 309-3133
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0133002014
VA
103K00000X
Behavior Analyst
Primary
1-19-39896
OH
103K00000X
Behavior Analyst
COBA.00646
OH
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133002014
VIRGINIA BOARD OF MEDICINE
VA
01
—
1-19-39896
BEHAVIOR ANALYST CERTIFICATION BOARD
OH
01
—
COBA.00646
OHIO DEPARTMENT OF PSYCHOLOGY
OH
Enumeration date
08/09/2017
Last updated
09/09/2021
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