Provider Demographics
NPI:1821256892
Name:MOSELEY, MARY A (COTA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 OLD MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-7213
Mailing Address - Country:US
Mailing Address - Phone:828-524-7806
Mailing Address - Fax:
Practice Address - Street 1:3195 OLD MURPHY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7213
Practice Address - Country:US
Practice Address - Phone:828-524-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3865224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant