Individual
DEANNA C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
4501 RUSSELL PKWY STE 1CR, WARNER ROBINS, GA 31088-8678
(478) 714-1040
Mailing address
328 AUDREY WAY, KATHLEEN, GA 31047-2166
(478) 714-1040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004692
GA
Other
Enumeration date
11/12/2008
Last updated
04/06/2010
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