Individual
LACEY MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CF -SLP
Contact information
Practice address
2202 S MAIN ST, GROVE, OK 74344-5328
(918) 964-7025
(918) 964-7024
Mailing address
2202 S MAIN ST, GROVE, OK 74344-5328
(918) 964-7025
(918) 964-7024
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF648
OK
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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