Alyssa G. Moomaw MS, CCC-SLP/L

NPI 1780947838 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1780947838
Gender Female
Enumeration Date 06/22/2012
Last Updated 06/22/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
1800 E LAKE SHORE DR
DECATUR IL, 62521-3810, US
Phone (217) 464-2966
Fax (217) 464-1633
Business Location
1800 E LAKE SHORE DR
DECATUR IL, 62521-3810, US
Phone (217) 464-2966
Fax (217) 464-1633
Toxanomy
Taxonomy Code 235Z00000X
License State Illinois
License Number 146009778
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According to our database, Mrs. Alyssa G. Moomaw MS, CCC-SLP/L NPI is 1780947838, taxonomy code is 235Z00000X and license number is 146009778, license state is located at Illinois. Alyssa G. Moomaw MS, CCC-SLP/L physically located at 1800 E Lake Shore Dr, Decatur IL, 62521-3810. NPI Number Alyssa G. Moomaw MS, CCC-SLP/L has the Individual type.

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1780947838 NPI number is provided on an as is basis without warranty of any kind. 1780947838 is maintained by the National Plan & Provider Enumeration System. The contents of Alyssa G. Moomaw MS, CCC-SLP/L are for informational purposes only.