Most Relevant Information
Provider Data
| NPI Number: | 1003524620 |
| Provider Name: | ANIYAH NICHELLE MOORE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/14/2022 |
| Last Updated: | 11/14/2022 |
Provider Practice Location
560 E HOSPITALITY LN STE 400
SAN BERNARDINO
CA
924083545
Practice Location Phone/Fax
| Phone: | 9098911599 |
| Fax: |
Provider Mailing Location
11852 MOUNT VERNON AVE APT 672
GRAND TERRACE
CA
923138329
Provider Mailing Phone/Fax
| Phone: | 9513904323 |
| Fax: |