Individual
KRISTIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 S SUMMIT AVE, PRESCOTT, AZ 86303-4115
(360) 281-2025
Mailing address
311 S SUMMIT AVE, PRESCOTT, AZ 86303-4115
(360) 281-2025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP12656
AZ
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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