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NPI Code Detail

MEDICARE: VICTORIA MOORE MS, CCC-SLP

MEDICARE: VICTORIA MOORE MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1326763681
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA MOORE MS, CCC-SLP
Provider Business Mailing Address
First Line : 4171 S 15TH ST
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-7701
Country : US
Telephone Number : 262-894-1124
Fax Number :
Provider Business Practice Location Address
First Line : 3330 STAHL RD
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-8862
Country : US
Telephone Number : 920-459-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 05/18/2026

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Directions to “ VICTORIA MOORE MS, CCC-SLP” Practice Location

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