Individual
ELISABETH ANNE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
111 NATURE WALK PKWY, SUITE 101, ST. AUGUSTINE, FL 32092
(904) 230-7761
(904) 230-7763
Mailing address
6423 DARTMOUTH RD, JACKSONVILLE, FL 32217-2483
(904) 230-7761
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA5418
FL
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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