MEDICARE: HANNAH MOORE M.S. ED., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	116636	TX
2	235Z00000X	Speech-Language Pathologist	11239	NC

General Provider Information

NPI Number	:	1245768555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH MOORE M.S. ED., CCC-SLP

Provider Business Mailing Address
First Line	:	377 WALKERS GLEN WAY
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-9601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	377 WALKERS GLEN WAY
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-9601
Country	:	US
Telephone Number	:	828-450-2964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	08/28/2023

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Directions to “ HANNAH MOORE M.S. ED., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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