Doctor Name: | JESSICA MOELLER |
NPI Number: | 1770845752 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 007806 |
Business Practice Address: | 4651 Woodstock Rd Ste 208-202 Roswell, GA - 300751698 |
Business Phone Number: | 7707892257 |
Business Fax Number: | |
Mailing Address: | 4651 Woodstock Rd, Ste 208-202 ROSWELL |
State: | GA |
Postal Code: | 300751698 |
Phone Number: | 7707892257 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2012 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 007806 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |