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General NPI Number Information
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NPI Number | 1215700661
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Entity Type | Organization
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Legal Business Name | THRIVE MOORE THERAPY LLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 2705 W COLTON
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City | OZARK
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State | MO
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Zip | 65721-8047
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Country | US
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Telephone | 785-221-7815
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 W COLTON
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City | OZARK
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State | MO
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Zip | 65721-8047
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Country | US
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Telephone | 785-221-7815
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | DR. MALLORY MEGAN MOORE
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Credential | SLP.D., CCC-SLP
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Telephone | 785-221-7815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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