IndividualActive
Brian Moore
NPI 1891212130 · Early Intervention Provider Agency · Daytona Beach, FL
Provider details
- NPI number
- 1891212130
- Entity type
- Individual
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Agencies
- Behavior Technician106S00000X
Behavioral Health & Social Service Providers
Practice location
201 Thornberry Branch Ln
Daytona Beach, FL 32124
Phone: (386) 872-4892
Approximate (ZIP-level) locationGet directions
Mailing address
2306 Brian Ave
South Daytona, FL 32119-2724
Registry dates
- Enumerated
- 2017-08-28
- Last updated
- 2018-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.