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NPI Code Detail

MEDICARE: MARGARET M MOORE BCBA

MEDICARE:   MARGARET M MOORE  BCBA
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
1103K00000XBehavior Analyst1-11-8077IN

General Provider Information

NPI Number : 1922382266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET M MOORE BCBA
Provider Business Mailing Address
First Line : 12650 HAMILTON CROSSING BLVD
Second Line :
City : CARMEL
State : IN
Zip : 46032-5400
Country : US
Telephone Number : 317-249-2242
Fax Number : 317-663-1175
Provider Business Practice Location Address
First Line : 3361 36TH ST SE
Second Line :
City : KENTWOOD
State : MI
Zip : 49512-2809
Country : US
Telephone Number : 616-726-1952
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2011
Last Update Date : 03/03/2022

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