Provider Demographics
NPI:1831252295
Name:MOORE, MORGAN SIGMON (MS SPEECH PATH)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:SIGMON
Last Name:MOORE
Suffix:
Gender:F
Credentials:MS SPEECH PATH
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:ELAINE
Other - Last Name:SIGMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1087 13TH ST SE
Mailing Address - Street 2:CHILDRENS NEUORTHERAPY SERVICES
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4165
Mailing Address - Country:US
Mailing Address - Phone:828-267-1688
Mailing Address - Fax:828-267-1690
Practice Address - Street 1:1087 13TH ST SE
Practice Address - Street 2:CHILDRENS NEUORTHERAPY SERVICES
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4165
Practice Address - Country:US
Practice Address - Phone:828-267-1688
Practice Address - Fax:828-267-1690
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11695504OtherCAQH
NC193033OtherMEDCOST
NC7412686Medicaid
NC143GCOtherBCBS
NC9450914OtherPHCS