| Doctor Name: | MELISSA A MOORE |
| NPI Number: | 1043487325 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A.CCC-SLP |
| License Number: | 17481 |
| Business Practice Address: | 1030 E Highway 377 202 Granbury, TX - 760481456 |
| Business Phone Number: | 8173727380 |
| Business Fax Number: | |
| Mailing Address: | 1433 Pine Ln, FORT WORTH |
| State: | TX |
| Postal Code: | 761405431 |
| Phone Number: | 8175516353 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2008 |
| NPI Last Update Date: | 08/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 17481 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| 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 |