Individual
JACQUELINE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS SLP
Contact information
Practice address
5980 RADIO STATION RD, LA PLATA, MD 20646-3337
(301) 932-6610
Mailing address
60 FREEDOM RD, SEWELL, NJ 08080-1833
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
MD
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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