Individual
SHELLEY R MOATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1050 E MARKET ST STE 1, LOUISVILLE, KY 40206-1874
(502) 588-9587
(502) 588-9580
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
0465
KY
231H00000X
Audiologist
Primary
101740
KY
237600000X
Audiologist-Hearing Aid Fitter
100528
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200864840
—
IN
01
—
50009966
PASSPORT
KY
05
—
70001268
—
KY
Enumeration date
08/23/2005
Last updated
09/21/2021
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