Individual
MS. JANICE LYNN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC CCCSLP
Contact information
Practice address
1700 RIDGE ROAD, GREENVILLE, SC 29607-4730
(864) 288-2390
Mailing address
207 TIMBER LN, GREENVILLE, SC 29609-1535
(864) 235-1393
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
943
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0092
—
SC
Enumeration date
05/23/2007
Last updated
03/19/2008
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