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General NPI Number Information
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NPI Number | 1326510504
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Entity Type | Individual
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Provider Name | TOMEKIA E MOORE
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Gender | Female
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 2610 E 3RD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1791
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Country | US
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Telephone | 404-707-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 SHOLAR AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37406-2845
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Country | US
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Telephone | 423-840-0094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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