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General NPI Number Information
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NPI Number | 1649861428
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Entity Type | Organization
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Legal Business Name | MOEDER BEHAVIORAL CONSULTING, LLC
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 628 FOX ST
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City | NEW BREMEN
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State | OH
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Zip | 45869-1018
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Country | US
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Telephone | 513-432-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 628 FOX ST
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City | NEW BREMEN
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State | OH
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Zip | 45869-1018
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Country | US
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Telephone | 513-432-4385
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | ANTHONY MOEDER
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Credential | BCBA
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Telephone | 513-432-4385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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