Mary Moore

NPI #1184239865 in La Grange Park, Illinois

Provider Information

NPI Number: 1184239865
Entity Type: Individual
Name: Mary Moore
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Sep 10, 2020
Last Updated: Sep 10, 2020

Practice Location

Address: 306 N KENSINGTON AVE
City: La Grange Park
State: Illinois
ZIP Code: 60526-1870
Phone: (312) 965-2997

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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