Doctor Name: | MISS ANN M MOORE |
NPI Number: | 1467573386 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 04902 |
Business Practice Address: | 3168 Braverton St Suite 200 Edgewater, MD - 210372674 |
Business Phone Number: | 4109567868 |
Business Fax Number: | 4109567998 |
Mailing Address: | 645 Baltimore Annapolis Blvd, Suite 217 SEVERNA PARK |
State: | MD |
Postal Code: | 211463931 |
Phone Number: | 4103849129 |
Fax Number: | 4103849725 |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 04902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |