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Tyler Moulton, BSBI
NPI 1861016339 · on the registry since 2020 · sole proprietor
Practice
- Address
- 420 Cardinal Dr
Shelley, ID 83274 - Phone
- (208) 360-4210
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- Behavior Technician
106S00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-06-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho