Individual
MISS MAKAYLA DAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
(419) 747-4126
Mailing address
806 STRAUB RD W APT 35, LEXINGTON, OH 44904-1899
(419) 989-0382
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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