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General NPI Number Information
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NPI Number | 1396467676
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Entity Type | Individual
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Provider Name | CATHERINE ROSE MOFFITT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 800 E CITY HALL AVE
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City | NORFOLK
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State | VA
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Zip | 23510-2723
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Country | US
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Telephone | 757-531-3118
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Fax |
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Provider Business Mailing Address
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Address Line | 4932 LIMESTONE AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4430
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Country | US
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Telephone | 734-751-9919
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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 | 2204001025
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License Number State | VA
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