Provider Demographics
NPI:1750776860
Name:MOOREN, EMILY ANNE (AUD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANNE
Last Name:MOOREN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2580 CHAPEL HILL DR
Mailing Address - Street 2:
Mailing Address - City:HORTONVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54944-9175
Mailing Address - Country:US
Mailing Address - Phone:920-213-2505
Mailing Address - Fax:
Practice Address - Street 1:N2580 CHAPEL HILL DR
Practice Address - Street 2:
Practice Address - City:HORTONVILLE
Practice Address - State:WI
Practice Address - Zip Code:54944-9175
Practice Address - Country:US
Practice Address - Phone:920-213-2505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI351-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist