| Doctor Name: | MRS. HOLLY KEBODEAUX MOORE |
| NPI Number: | 1417367897 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L-SLP; CCC-SLP |
| License Number: | 6469 |
| Business Practice Address: | 211 N 3rd St Suite 1 Monroe, LA - 712016731 |
| Business Phone Number: | 3183228974 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1462, MONROE |
| State: | LA |
| Postal Code: | 712101462 |
| Phone Number: | 3189531380 |
| Fax Number: | 3183228290 |
| NPI Enumeration Date: | 05/06/2014 |
| NPI Last Update Date: | 09/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 6469 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| 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 |