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1134258858
KIMBERLY DIANE MOORE
TAMPA, FL
NPI
1134258858
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Former Name
KIMBERLY DIANE BRADDOCK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA6405)
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Mrs. KIMBERLY DIANE MOORE MS CCCSLP
6508 GUNN HIGHWAY
TAMPA, FL 33625-4022
Phone number: 813-963-6923
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Mailing Address
Mrs. KIMBERLY DIANE MOORE MS CCCSLP
6508 GUNN HIGHWAY INDEPENDENT LIVING INC
TAMPA, FL 33625-4022
Phone number: 813-963-6923
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