Healthcare Provider Details

I. General information

NPI: 1336002138
Provider Name (Legal Business Name): JOSEPH MORE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 NAJOLES RD STE K-M
MILLERSVILLE MD
21108-2676
US

IV. Provider business mailing address

1314 HALLOCK DR
ODENTON MD
21113-2148
US

V. Phone/Fax

Practice location:
  • Phone: 443-800-8712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: