Individual
MALLORY NICOLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
101 CHAPMAN HILL RD STE 101, CLEMSON, SC 29631-2194
(864) 653-4071
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6252
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7188
SC
235Z00000X
Speech-Language Pathologist
9698
NC
Other
Enumeration date
07/11/2013
Last updated
06/10/2020
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