Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Moore

Individual provider Speech-Language Pathologist · NPI 1073469995

Shannon Moore is a Qualified Speech Language Pathologist in Middletown, New Jersey. Qualified in 2018, 8 years ago. Licensed in New Jersey.

Years since qualifying
8
Licensed in
NJ
In the registry since
2026
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Practice location Address checks out

1805 Evans Ln
Middletown, NJ 07748-1883
Phone: (609) 638-6723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 41YS01003200 (NJ)

Record details

NPI number1073469995
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 5, 2026
Last updated in NPPESMarch 5, 2026
Certification dateMarch 3, 2026
Mailing address633 W 5th St Ofc 2876b, Los Angeles, CA 90071-2005

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Middletown