| NPI | 1336645738 |
|---|---|
| Former Name | BETHANY MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-21-55603) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-18-52562) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-05-06 |