Individual
MRS. TAMARA S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
4218 W MORRIS HILL RD, BOISE, ID 83706-1949
(208) 284-0849
Mailing address
4218 W MORRIS HILL RD, BOISE, ID 83706-1949
(208) 284-0849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2008006403
MO
235Z00000X
Speech-Language Pathologist
Primary
SLP-1813
ID
Other
Enumeration date
04/21/2008
Last updated
12/09/2014
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