Provider Demographics
NPI:1619253788
Name:MOSLENER, RONALD WALTER (DMIN)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WALTER
Last Name:MOSLENER
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 CLYDESDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2508
Mailing Address - Country:US
Mailing Address - Phone:724-847-6629
Mailing Address - Fax:
Practice Address - Street 1:219 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2301
Practice Address - Country:US
Practice Address - Phone:724-775-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist