Individual
MIRANDA KAY MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
4209 AVA LN, MONROE, LA 71201-2099
(318) 361-5057
Mailing address
4209 AVA LN, MONROE, LA 71201-2099
(318) 361-5057
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4892
LA
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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