Individual
MS. LAURA ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 67TH AVE NE, FRIDLEY, MN 55432-4579
(763) 571-9316
Mailing address
1001 67TH AVE NE, FRIDLEY, MN 55432-4579
(763) 571-9316
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7748
MN
Other
Enumeration date
04/14/2007
Last updated
07/08/2007
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