Individual
ANGIE SUZANNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
324 STEVENS ENTRY, PEACHTREE CITY, GA 30269-1325
(678) 619-0178
(678) 701-1139
Mailing address
106 ROCKY BAY LN, SENOIA, GA 30276-6721
(770) 599-4490
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004851
GA
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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