Provider Demographics
NPI:1316572811
Name:MOSLEY, NIA AALEYA
Entity Type:Individual
Prefix:
First Name:NIA
Middle Name:AALEYA
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NIA
Other - Middle Name:AALEYA
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4620 VAN BUREN BLVD APT 110
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-2689
Mailing Address - Country:US
Mailing Address - Phone:910-603-5333
Mailing Address - Fax:
Practice Address - Street 1:4620 VAN BUREN BLVD APT 110
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-2689
Practice Address - Country:US
Practice Address - Phone:910-603-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer