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Individual

MRS. KATHRYN GRAGE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
3200 POINTE PKWY STE 200, PEACHTREE CORNERS, GA 30092-3370
(770) 639-1172
Mailing address
3200 POINTE PKWY STE 200, PEACHTREE CORNERS, GA 30092-3370
(770) 639-1172

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008015
GA

Other

Enumeration date
01/27/2018
Last updated
01/27/2018
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