Moore, Stacy M

Moore, Stacy M is an individual health care provider with primary practice located at 4369 Miller Rd , Flint MI 48507-1279. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, which is considered as her primary health care specialty. Moore, Stacy M can be contacted via phone (810) 733-1385.

Contact Information

Primary practice address
4369 Miller Rd Flint MI 48507-1279
Phone: (810) 733-1385
Fax: (810) 733-7893
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 12046396 Michigan
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 3501003257 Michigan
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 1601000313 Michigan

Profile Details

NPI number 1386685121
LBN Legal business name Moore, Stacy M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Jan 14th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386685121 NPPES
Michigan MEDICAID 1386685121

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