# DR. STACIA ADAIR MOORE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1851394902
- **Gender:** F
- **Credential:** AU.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | AU795 | MT | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 10/20/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0533851 | — | MT |
| 05 | — | 0561629 | — | MT |
| 01 | — | 290408 | BLUE CROSS BLUE SHIELD | MT |