Individual
PAMELA RENE MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 486-6000
Mailing address
6921 W VOLTAIRE AVE, PEORIA, AZ 85381-5059
(623) 878-5006
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0669
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624636
—
AZ
Enumeration date
03/01/2007
Last updated
07/09/2007
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