Individual provider Active NPI

Gabrielle Holder Moore, M.S. CCC LIC./SLP

  • Speech-Language Pathologist
  • Buffalo, NY
National Provider Identifier
1528375722
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008266-1 Issued in NY
Practice address
118 Hampshire St
School 18
Buffalo, NY 14213-2014
Phone
(716) 816-3160
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 008266-1 NY Primary

Addresses

Primary practice location

118 Hampshire St
School 18
Buffalo, NY 14213-2014

Mailing address

33 Ash St
School 12, Speech Department
Buffalo, NY 14204-1445
Phone (716) 816-4410

Other names 1

  • Gabrielle Jenene Holder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
008266-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1528375722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ASH ST",
            "address_2": "SCHOOL 12, SPEECH DEPARTMENT",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142041445",
            "telephone_number": "716-816-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 HAMPSHIRE ST",
            "address_2": "SCHOOL 18",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132014",
            "telephone_number": "716-816-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GABRIELLE",
        "middle_name": "HOLDER",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC LIC./SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008266-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "HOLDER",
            "middle_name": "JENENE",
            "credential": "M.S. CCC LIC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.