Individual
LORNESHIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3760 LAVISTA RD STE 102, TUCKER, GA 30084-5622
(678) 626-0557
Mailing address
3760 LAVISTA RD STE 102, TUCKER, GA 30084-5622
(678) 626-0557
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28641
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-28641
BCBA
—
Enumeration date
01/21/2018
Last updated
01/21/2018
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