Provider Demographics
NPI:1386018315
Name:MOSSER, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MOSSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9914 WARWICK PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-9249
Mailing Address - Country:US
Mailing Address - Phone:703-615-1438
Mailing Address - Fax:540-628-0446
Practice Address - Street 1:556 GARRISONVILLE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7826
Practice Address - Country:US
Practice Address - Phone:540-602-7615
Practice Address - Fax:540-628-0446
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006379101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health