Healthcare Provider Details

I. General information

NPI: 1306487145
Provider Name (Legal Business Name): SHEREESE MOYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 MARYLAND WAY STE 320
BRENTWOOD TN
37027-7591
US

IV. Provider business mailing address

5017 CLOVERHILL DR
MURFREESBORO TN
37128-3703
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-9337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: