Doctor Name: | MS. MARY CAROLYN MOORE |
NPI Number: | 1003844341 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSR, SLP |
License Number: | 3986 |
Business Practice Address: | 29 N Academy St Greenville, SC - 296012629 |
Business Phone Number: | 8643311380 |
Business Fax Number: | |
Mailing Address: | 1 Independence Pt, Suite 212 GREENVILLE |
State: | SC |
Postal Code: | 296154545 |
Phone Number: | 8647976307 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 04/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3986 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |