Moon, Elizabeth

Moon, Elizabeth is an sole proprietor health care provider with primary practice located at 1650 W Main St Ste 1 , Leesburg FL 34748-2842. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Moon, Elizabeth can be contacted via phone (352) 314-3760.

Contact Information

Primary practice address
1650 W Main St Ste 1 Leesburg FL 34748-2842
Fax: (352) 314-2909
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-18-56348 Florida

Profile Details

NPI number 1487259743
LBN Legal business name Moon, Elizabeth
Credentials RBT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2020
Last updated Dec 3rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487259743 NPPES
Florida MEDICAID 103989300

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