| NPI | 1336435064 |
|---|---|
| Former Name | MARIANNE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007824) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AL 3730) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-07-15 |