Individual
MALINDA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1046 6TH AVE SW, PHYSICAL REHAB DEPT, ALBANY, OR 97321-1916
(541) 812-4162
(541) 812-4614
Mailing address
522 7TH AVE SW, ALBANY, OR 97321-2316
(541) 928-1403
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10477
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10477
LICENSE
OR
Enumeration date
04/12/2007
Last updated
07/08/2007
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