Healthcare Provider Details

I. General information

NPI: 1093671158
Provider Name (Legal Business Name): MOORE MOTOR SPEECH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5-11 SADDLE RIVER RD
FAIR LAWN NJ
07410-5635
US

IV. Provider business mailing address

5-11 SADDLE RIVER RD
FAIR LAWN NJ
07410-5635
US

V. Phone/Fax

Practice location:
  • Phone: 973-747-0456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MOORE
Title or Position: OWNER/SLP
Credential: EDD CCC-SLP
Phone: 974-747-0456