Logan B Moody

NPI #1699470096 in Kennett, Missouri

Provider Information

NPI Number: 1699470096
Entity Type: Individual
Name: Logan B Moody
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 4, 2023
Last Updated: Apr 4, 2023

Practice Location

Address: 925 STATE ROUTE VV
City: Kennett
State: Missouri
ZIP Code: 63857-3822
Phone: (573) 888-5925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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