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General NPI Number Information
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NPI Number | 1043487325
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Entity Type | Individual
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Provider Name | MELISSA A MOORE M.A.CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1030 E HIGHWAY 377 202
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City | GRANBURY
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State | TX
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Zip | 76048-1456
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Country | US
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Telephone | 817-372-7380
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Fax |
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Provider Business Mailing Address
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Address Line | 1433 PINE LN
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City | FORT WORTH
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State | TX
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Zip | 76140-5431
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Country | US
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Telephone | 817-551-6353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 17481
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License Number State | TX
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