Individual
MRS. KATESSA NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
7304 RED PINE DR, FORT SMITH, AR 72916-8805
(479) 518-0692
Mailing address
7304 RED PINE DR, FORT SMITH, AR 72916-8805
(479) 518-0692
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
P7994
AR
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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