Susan A. Moore, MS CCC/SLP

Individual provider Active NPI Speech-Language Pathologist · Hyde Park, VT

NPI 1699097964 · NPPES record last updated Feb 26, 2010

Key facts

NPI
1699097964
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
6 84 (VT)
Practice address
114 Langdell Road
Hyde Park, VT 05655
Phone
(802) 888-5578
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6 84VTMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6 84 VT Yes

Addresses

Primary practice location

114 Langdell Road
Hyde Park, VT 05655

Mailing address

PO Box 34
North Hyde Park, VT 05665-0034
Phone (802) 888-5578

Other providers in Hyde Park, VT

All providers in Hyde Park, VT · Speech-Language Pathologist in Vermont

Sources for this page

Verify at the official NPI Registry.