Individual
DEZREK MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MARQUETTE AVE NW STE 1200, ALBUQUERQUE, NM 87102-5312
(505) 522-7750
Mailing address
517 N CONNELLY ST, CLOVIS, NM 88101-7337
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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