MEDICARE: MRS. CAROLINE ELIZABETH MOORE M.ED., M.A. 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	SA13018	FL
2	235Z00000X	Speech-Language Pathologist	SP-6113	OH
3	235Z00000X	Speech-Language Pathologist	280800	KY
4	235Z00000X	Speech-Language Pathologist	8570	TN

General Provider Information

NPI Number	:	1669656328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLINE ELIZABETH MOORE M.ED., M.A. CCC/SLP

Provider Business Mailing Address
First Line	:	1005 RAIL WAY
Second Line	:
City	:	COSBY
State	:	TN
Zip	:	37722-3414
Country	:	US
Telephone Number	:	423-608-2885
Fax Number	:	865-761-4045

Provider Business Practice Location Address
First Line	:	642 COSBY HWY
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-3418
Country	:	US
Telephone Number	:	423-608-2885
Fax Number	:	865-761-4045

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

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	12/10/2025

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Directions to “ MRS. CAROLINE ELIZABETH MOORE M.ED., M.A. CCC/SLP” Practice Location

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