Most Relevant Information
Provider Data
| NPI Number: | 1003426461 |
| Provider Name: | NATHANIEL J MOORE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/31/2020 |
| Last Updated: | 11/27/2023 |
Provider Practice Location
382 RACETRACK RD
MCDONOUGH
GA
302521022
Practice Location Phone/Fax
| Phone: | 6786912206 |
| Fax: |
Provider Mailing Location
2472 JETT FERRY RD STE 400-197
ATLANTA
GA
303383059
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |