Provider Demographics
NPI:1417268749
Name:MOORE COMMUNICATION CONNECTIONS
Entity Type:Organization
Organization Name:MOORE COMMUNICATION CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:REVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:866-570-0442
Mailing Address - Street 1:14625 BALTIMORE AVE
Mailing Address - Street 2:SUITE 864
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4902
Mailing Address - Country:US
Mailing Address - Phone:866-570-0442
Mailing Address - Fax:
Practice Address - Street 1:7909 BELLE POINT DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3329
Practice Address - Country:US
Practice Address - Phone:866-570-0442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty