Provider Demographics
NPI:1477943074
Name:MOSER, GAILLA (LMSW)
Entity Type:Individual
Prefix:
First Name:GAILLA
Middle Name:
Last Name:MOSER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 MARTY ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2557
Mailing Address - Country:US
Mailing Address - Phone:913-952-6696
Mailing Address - Fax:913-649-2567
Practice Address - Street 1:10550 MARTY ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2557
Practice Address - Country:US
Practice Address - Phone:913-952-6696
Practice Address - Fax:913-649-2567
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4640104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker