Provider Demographics
NPI:1407008527
Name:MOORE, DEBBIE H
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:H
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 CRAIGMONT DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-4827
Mailing Address - Country:US
Mailing Address - Phone:901-385-2798
Mailing Address - Fax:
Practice Address - Street 1:801 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-5735
Practice Address - Country:US
Practice Address - Phone:870-735-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist