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Individual
DR. STACIA ADAIR MOORE
Active
Individual
DR. STACIA ADAIR MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU795
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0533851
—
MT
05
—
0561629
—
MT
01
—
290408
BLUE CROSS BLUE SHIELD
MT
Enumeration date
05/23/2005
Last updated
10/20/2011
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