Individual ProviderDestiny MooreBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address225 Cedar Street, 200, Marlborough, MA 01752-0175(919) 810-8061PECOS EnrollmentBased on the most recent information from CMS, provider Destiny Moore does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1629778410Provider TypeIndividualFull NameMoore, DestinyGenderFemaleSole ProprietorNoEnumeration Date3/9/2023Last Updated3/13/2023Contact InformationPractice LocationPractice Address225 Cedar Street, 200, Marlborough, MA 01752-0175Phone(919) 810-8061FaxUnlisted FaxMailing LocationMailing Address225 Cedar Street, 200, Marlborough, MA 01752PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID106S00000XDescriptionMedicaidIssuerUnlistedMassachusetts