Provider Demographics
NPI:1306714936
Name:OHALE, MOSES
Entity type:Individual
Prefix:
First Name:MOSES
Middle Name:
Last Name:OHALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 HALES BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-9323
Mailing Address - Country:US
Mailing Address - Phone:443-915-2593
Mailing Address - Fax:
Practice Address - Street 1:147 HALES BRANCH DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-9323
Practice Address - Country:US
Practice Address - Phone:443-915-2593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171400000XOther Service ProvidersHealth & Wellness Coach