Melieyah Moore

Individual provider Active NPI Behavior Technician · Wallace, NC

NPI 1992599534 · NPPES record last updated Apr 8, 2025

Key facts

NPI
1992599534
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
133 Glendale Village LN
Wallace, NC 28466-1637
Phone
(910) 619-0846
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
521967NCMDNurse's Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 521967 NC
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

133 Glendale Village LN
Wallace, NC 28466-1637

Mailing address

133 Glendale Village LN
Wallace, NC 28466-1637
Phone (910) 619-0846

Other providers in Wallace, NC

All providers in Wallace, NC · Behavior Technician in North Carolina

Sources for this page

Verify at the official NPI Registry.