Moody, Sandra D.

Moody, Sandra D. is an sole proprietor health care provider with primary practice located at 174 Watercolor Way Suite 103 Box 324, Santa Rosa Beach FL 32459-7350. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Moody, Sandra D. can be contacted via phone (850) 323-1178.

Contact Information

Primary practice address
174 Watercolor Way Suite 103 Box 324 Santa Rosa Beach FL 32459-7350
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA 2173 Florida

Profile Details

NPI number 1548578057
LBN Legal business name Moody, Sandra D.
Credentials MS/SLP/CCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 17th, 2010
Last updated Jul 18th, 2013 - about 11 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 1548578057 NPPES
Georgia MEDICAID 00804625A
Georgia Other SA 2173

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