Provider Demographics
NPI:1164542627
Name:MOSIER, CAROL R (SPEECH PATHLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:R
Last Name:MOSIER
Suffix:
Gender:F
Credentials:SPEECH PATHLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 W ROPER LN
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-7344
Mailing Address - Country:US
Mailing Address - Phone:928-649-0081
Mailing Address - Fax:
Practice Address - Street 1:40004 N LIBERTY BELL WAY
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-4614
Practice Address - Country:US
Practice Address - Phone:623-445-8092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist