Individual
SHANNON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1805 EVANS LN, MIDDLETOWN, NJ 07748-1883
(609) 638-6723
Mailing address
633 W 5TH ST OFC 2876B, LOS ANGELES, CA 90071-2005
(512) 377-6318
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01003200
NJ
Other
Enumeration date
03/05/2026
Last updated
03/05/2026
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