Doctor Name: | AMY DEICHERT MOSS |
NPI Number: | 1083059315 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS-SP-CCC |
License Number: | SA 574 |
Business Practice Address: | 3627 University Blvd S Suite 210 Jacksonville, FL - 322164230 |
Business Phone Number: | 9043995311 |
Business Fax Number: | 9043962520 |
Mailing Address: | 6318 Falbridge Ct, JACKSONVILLE |
State: | FL |
Postal Code: | 322589435 |
Phone Number: | 9043183159 |
Fax Number: | 9043962520 |
NPI Enumeration Date: | 04/30/2013 |
NPI Last Update Date: | 04/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 574 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |