Provider Demographics
NPI:1407557275
Name:MORAN, CHRISTINA (RBT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MORAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 STONERIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:HELMETTA
Mailing Address - State:NJ
Mailing Address - Zip Code:08828-1138
Mailing Address - Country:US
Mailing Address - Phone:718-974-4349
Mailing Address - Fax:
Practice Address - Street 1:1210 STONERIDGE CIR
Practice Address - Street 2:
Practice Address - City:HELMETTA
Practice Address - State:NJ
Practice Address - Zip Code:08828-1138
Practice Address - Country:US
Practice Address - Phone:718-974-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ17-37965106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician