Individual
CHRISTINA L MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
4214 SHERIDAN RD, MT PLEASANT, WI 53403-4142
(262) 554-5006
Mailing address
4214 SHERIDAN RD, MT PLEASANT, WI 53403-4142
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4663-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174176770
—
WI
Enumeration date
07/23/2019
Last updated
06/04/2020
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