Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Moon River, LLC

Organization Behavior Analyst · NPI 1730143553

Moon River, LLC is a Behavior Analyst in Marietta, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
Specialties on file
10
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

790 Oak Trail Dr
Marietta, GA 30062-7502
Phone: (770) 977-6866
Fax: (770) 977-6887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X
Psychologist Taxonomy 103T00000X
Physical Therapist Taxonomy 225100000X · Licence PT003833 (GA)
Pediatric Occupational Therapist Taxonomy 225XP0200X · Licence OT 004293 (GA)
Pediatric Occupational Therapist Taxonomy 225XP0200X · Licence GAOT001717 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP003992 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP005806 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP006528 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP 06551 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP 006556 (GA)

Record details

NPI number1730143553
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laura Desantis — Office Manager · (770) 212-2170
NPI enumeratedApril 17, 2006
Last updated in NPPESFebruary 18, 2025
Certification dateFebruary 18, 2025
Mailing address790 Oak Trail Dr, Marietta, GA 30062-7502

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