Doctor Name: | ALICIA SIERRA MOSS |
NPI Number: | 1962823856 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CF -SLP |
License Number: | 2202007245 |
Business Practice Address: | 6688 Main St Gloucester, VA - 230615194 |
Business Phone Number: | 8042101555 |
Business Fax Number: | 8042101556 |
Mailing Address: | 204 Armstrong Dr Apt 3, HAMPTON |
State: | VA |
Postal Code: | 236694417 |
Phone Number: | 8046871114 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2013 |
NPI Last Update Date: | 12/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202007245 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |