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1770061988
CARISSA JENAY MOORE
FREDERICKSBURG, VA
NPI
1770061988
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-07-31
Last Update Date
2018-07-31
Business Address
CARISSA JENAY MOORE
1411 PRINCESS ANNE STREET
FREDERICKSBURG, VA 22401
Phone number: 540-922-1110
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Mailing Address
CARISSA JENAY MOORE
19050 FULLER HEIGHTS RD APT 119
TRIANGLE, VA 22172-2141
Phone number: 571-285-9486
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