Provider Demographics
NPI:1518902808
Name:MOSS, ANN HARDY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:HARDY
Last Name:MOSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:258 E GARRISON BLVD
Mailing Address - Street 2:P.O BOX 3984
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0460
Mailing Address - Country:US
Mailing Address - Phone:704-861-8405
Mailing Address - Fax:704-865-0590
Practice Address - Street 1:258 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0460
Practice Address - Country:US
Practice Address - Phone:704-861-8405
Practice Address - Fax:704-865-0590
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional