Individual
MOLLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
976 REDSTONE RD, DACULA, GA 30019-7415
(770) 995-2345
(678) 392-4401
Mailing address
976 REDSTONE RD, DACULA, GA 30019-7415
(770) 995-2345
(678) 392-4401
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006040
GA
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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