Individual
MRS. CAROLYN DIANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1544 GREENLY ST, HUDSONVILLE, MI 49426-9674
(616) 914-0648
Mailing address
1544 GREENLY ST, HUDSONVILLE, MI 49426-9674
(616) 914-0648
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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