| Doctor Name: | BIANCA SADE MOSS |
| NPI Number: | 1063825669 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ST |
| License Number: | 3847 |
| Business Practice Address: | 2129 West Street Suite 224 Germantown, TN - 38138 |
| Business Phone Number: | 8665637772 |
| Business Fax Number: | 9012550758 |
| Mailing Address: | 2129 West Street, Suite 224 GERMANTOWN |
| State: | TN |
| Postal Code: | 38138 |
| Phone Number: | 8665637772 |
| Fax Number: | 9012550758 |
| NPI Enumeration Date: | 06/11/2014 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3847 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| 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 |