Doctor Name: | DR. HEATHER BAIR MOORE |
NPI Number: | 1558589259 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 12896 |
Business Practice Address: | 111 N 20th St Philomath, OR - 973709621 |
Business Phone Number: | 5413684313 |
Business Fax Number: | |
Mailing Address: | 3524 Se Shoreline Dr, CORVALLIS |
State: | OR |
Postal Code: | 973333208 |
Phone Number: | 5412318799 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
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 |