| Doctor Name: | SANDRA D. MOODY |
| NPI Number: | 1548578057 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS/SLP/CCC |
| License Number: | SA 2173 |
| Business Practice Address: | 174 Watercolor Way Suite 103 Box 324 Santa Rosa Beach, FL - 324597350 |
| Business Phone Number: | 8503231178 |
| Business Fax Number: | |
| Mailing Address: | 174 Watercolor Way, Suite 103 Box 324 SANTA ROSA BEACH |
| State: | FL |
| Postal Code: | 324597350 |
| Phone Number: | 8503231178 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2010 |
| NPI Last Update Date: | 07/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 2173 |
| 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 |