Provider Demographics
NPI:1851514780
Name:MOSIMAN, GIDGET ANN (MS LPC)
Entity Type:Individual
Prefix:
First Name:GIDGET
Middle Name:ANN
Last Name:MOSIMAN
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661
Mailing Address - Country:US
Mailing Address - Phone:785-543-5284
Mailing Address - Fax:785-543-5285
Practice Address - Street 1:783 7TH ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661
Practice Address - Country:US
Practice Address - Phone:785-628-2871
Practice Address - Fax:785-628-1438
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC1850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional