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NPI Code Detail

MEDICARE: GLENNA MOORHEAD RBT

MEDICARE: GLENNA MOORHEAD RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194393082
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENNA MOORHEAD RBT
Provider Business Mailing Address
First Line : 1051 PINELOCH DR STE 400
Second Line :
City : HOUSTON
State : TX
Zip : 77062-2739
Country : US
Telephone Number : 281-461-6888
Fax Number : 866-237-5824
Provider Business Practice Location Address
First Line : 1051 PINELOCH DR STE 900
Second Line :
City : HOUSTON
State : TX
Zip : 77062-2746
Country : US
Telephone Number : 281-461-6888
Fax Number : 866-237-5824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2021
Last Update Date : 06/16/2021

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Directions to “ GLENNA MOORHEAD RBT” Practice Location

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