Individual
MRS. STEPHANIE ANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP
Contact information
Practice address
117 SPRATT ST STE B, FORT MILL, SC 29715-4111
(704) 931-1010
Mailing address
117 SPRATT ST STE B, FORT MILL, SC 29715-4111
(704) 931-1010
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7555
SC
235Z00000X
Speech-Language Pathologist
9245
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7555
STATE OF SOUTH CAROLINA
SC
Enumeration date
11/17/2009
Last updated
09/28/2022
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