Janet Miller Moore
Individual provider Active NPI Behavior Analyst · Freeport, FL
NPI 1164578878 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1164578878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-08-4814 (FL)
- Practice address
- 138 Campfire CV
Freeport, FL 32439-2595 - Phone
- (904) 502-9272
- Fax
- (904) 276-7078
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Behavioral Group, Inc. | Behavior Analyst | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-08-4814 | FL | Yes |
Addresses
Primary practice location
138 Campfire CV
Freeport, FL 32439-2595
Mailing address
138 Campfire CV
Freeport, FL 32439-2595
Phone (904) 502-9272
Other providers in Freeport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.