Provider Demographics
NPI:1912538794
Name:MOORE, EMILY CHRISTINE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CHRISTINE
Last Name:MOORE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CHRISTINE
Other - Last Name:GOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2557 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4712
Mailing Address - Country:US
Mailing Address - Phone:980-320-8275
Mailing Address - Fax:704-973-7862
Practice Address - Street 1:2557 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4712
Practice Address - Country:US
Practice Address - Phone:980-320-8275
Practice Address - Fax:704-973-7862
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist