Individual
AUTUMN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
319 N PINE ST, LITTLE ROCK, AR 72205-4215
(501) 447-5919
Mailing address
1203 WILD TURKEY CT, LITTLE ROCK, AR 72211-2451
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#P9101
AR
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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