Individual
KATHLEEN D MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
16817 ZION ST NW, ANDOVER, MN 55304-2091
(651) 955-3327
Mailing address
16817 ZION ST NW, ANDOVER, MN 55304-2091
(651) 955-3327
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10182
MN
Other
Enumeration date
09/18/2018
Last updated
05/13/2024
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