Individual
MS. DEIDRE ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1060 E 86TH ST, SUITE 65C, INDIANAPOLIS, IN 46240-1863
(765) 621-3285
(317) 218-3462
Mailing address
PO BOX 40696, INDIANAPOLIS, IN 46240-0696
(765) 621-3285
(317) 218-3462
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002523A
IN
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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