Provider Demographics
NPI:1528953783
Name:MOORE, CALLEY WALKER (MS, CF- SLP)
Entity type:Individual
Prefix:
First Name:CALLEY
Middle Name:WALKER
Last Name:MOORE
Suffix:
Gender:X
Credentials:MS, CF- SLP
Other - Prefix:
Other - First Name:CALLEY
Other - Middle Name:WALKER
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:2601 SANDERSVILLE RD # 4099
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8847
Mailing Address - Country:US
Mailing Address - Phone:859-208-1400
Mailing Address - Fax:
Practice Address - Street 1:2601 SANDERSVILLE RD # 4099
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-8847
Practice Address - Country:US
Practice Address - Phone:502-321-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist