Doctor Name: | MRS. MARIANNE D MOONE |
NPI Number: | 1972701605 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC SLP |
License Number: | 703 |
Business Practice Address: | 187 Veterans Blvd Massapequa, NY - 117584982 |
Business Phone Number: | 5168261862 |
Business Fax Number: | |
Mailing Address: | 187 Veterans Blvd, MASSAPEQUA |
State: | NY |
Postal Code: | 117584982 |
Phone Number: | 5168261862 |
Fax Number: | 5168264449 |
NPI Enumeration Date: | 07/03/2007 |
NPI Last Update Date: | 05/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 703 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |