Provider Demographics
NPI:1477847903
Name:MOBLEY, JOANALEENE ALEDA (LMT, NCTM)
Entity Type:Individual
Prefix:
First Name:JOANALEENE
Middle Name:ALEDA
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:LMT, NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 700 RD
Mailing Address - Street 2:
Mailing Address - City:NEW OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:17350-8735
Mailing Address - Country:US
Mailing Address - Phone:717-479-1786
Mailing Address - Fax:
Practice Address - Street 1:624 700 RD
Practice Address - Street 2:
Practice Address - City:NEW OXFORD
Practice Address - State:PA
Practice Address - Zip Code:17350-8735
Practice Address - Country:US
Practice Address - Phone:717-479-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000777225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist