Moore, Mary

Moore, Mary is an individual health care provider with primary practice located at 306 N Kensington Ave , La Grange Park IL 60526-1870. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Moore, Mary can be contacted via phone (312) 965-2997.

Contact Information

Primary practice address
306 N Kensington Ave La Grange Park IL 60526-1870
Phone: (312) 965-2997
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1184239865
LBN Legal business name Moore, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2020
Last updated Sep 10th, 2020 - about 5 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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