Individual
MIRANDA R MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
185 S CHET KRAUSE DR, IOLA, WI 54945-9300
(715) 445-2412
Mailing address
10464 COUNTY ROAD B, AMHERST, WI 54406-8940
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2965-154
WI
Other
Enumeration date
05/23/2012
Last updated
05/25/2012
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