Individual
DIANE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
8585 W DAKOTA AVE, LAKEWOOD, CO 80226-3022
(303) 988-1448
Mailing address
5185 E 117TH AVE, THORNTON, THORNTON, CO 80233-1841
(303) 596-4620
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000959
CO
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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