Healthcare Provider Details

I. General information

NPI: 1366537607
Provider Name (Legal Business Name): SPEAK MOOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7368 N LA CHOLLA BLVD
TUCSON AZ
85741-2305
US

IV. Provider business mailing address

7368 N LA CHOLLA BLVD 7368 N. LA CHOLLA BLVD
TUCSON AZ
85741-2305
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-3092
  • Fax: 520-544-9497
Mailing address:
  • Phone: 520-742-3092
  • Fax: 520-544-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6540
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1060
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP0161
License Number StateAZ

VIII. Authorized Official

Name: MRS. SHERI B MOORMANN
Title or Position: SPEECH PATHOLOGIST/OWNER
Credential: M.S. CCC-SLP
Phone: 520-742-3092