Individual
ANN M MOFFITT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
16 EDENDERY CIR, FAIRPORT, NY 14450-1013
(585) 737-8545
Mailing address
16 EDENDERY CIR, FAIRPORT, NY 14450-1013
(585) 737-8545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
014292-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000927672001
HEALTH NOW
NY
01
—
7264573
AETNA
NY
01
—
PO10114292
BLUE CHOICE & MONROE PLAN
NY
Enumeration date
09/27/2006
Last updated
09/27/2011
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