Individual
MRS. CONNIE SUSAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC/SLP
Contact information
Practice address
1201 HAWTHORN RD, SALEM, IL 62881-1028
(618) 548-4884
(618) 548-2150
Mailing address
409 E 3RD ST, FLORA, IL 62839-2503
(618) 662-8934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12098284
IL
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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