Individual
KEISHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
305 MAPLE ST, EAST LONGMEADOW, MA 01028-2765
(413) 525-6361
Mailing address
21 HARLOW DR, NEWINGTON, CT 06111-3203
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2202005116
VA
235Z00000X
Speech-Language Pathologist
Primary
76813
MA
Other
Enumeration date
04/04/2007
Last updated
04/16/2018
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