Individual
MEGAN MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1893 JENNIE LEE DR APT 101, IDAHO FALLS, ID 83404-6161
(715) 566-0806
Mailing address
1893 JENNIE LEE DR APT 101, IDAHO FALLS, ID 83404-6161
(715) 566-0806
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17270
ID
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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