Individual
MS. DANIELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3756 LAVISTA RD, SUITE 104, TUCKER, GA 30084-5614
(404) 477-9400
Mailing address
405 JORDAN DR, TUCKER, GA 30084-2035
(404) 477-9400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004369
GA
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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