Provider Demographics
NPI:1437442654
Name:MOSES, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MOSES
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 1:16761 SOUTHPARK CENTER
Mailing Address - Street 2:STRONGSVILLE FAMILY HEALTH AND SURGERY CENTER
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136
Mailing Address - Country:US
Mailing Address - Phone:440-878-2500
Mailing Address - Fax:
Practice Address - Street 1:16761 SOUTHPARK CENTER
Practice Address - Street 2:STRONGSVILLE FAMILY HEALTH AND SURGERY CENTER
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136
Practice Address - Country:US
Practice Address - Phone:440-878-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7060103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical