Provider Demographics
NPI:1780573006
Name:MOATS, ROY ALLEN JR
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:ALLEN
Last Name:MOATS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5327 EMERSON AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-9097
Mailing Address - Country:US
Mailing Address - Phone:304-483-1847
Mailing Address - Fax:
Practice Address - Street 1:425 JULIANA ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5352
Practice Address - Country:US
Practice Address - Phone:304-893-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician