Individual
PETRA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9051 RIDGEFIELD DR, FREDERICK, MD 21701-6740
(227) 203-1340
Mailing address
10307 FOX CHASE CIR, NEW MARKET, MD 21774-6918
(701) 818-0887
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11639
MD
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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