Provider Demographics
NPI:1881845071
Name:MOSER, DEBBEY LOU (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DEBBEY
Middle Name:LOU
Last Name:MOSER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:MERTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19539-0174
Mailing Address - Country:US
Mailing Address - Phone:610-682-2098
Mailing Address - Fax:
Practice Address - Street 1:2125 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:LAURELDALE
Practice Address - State:PA
Practice Address - Zip Code:19605-2259
Practice Address - Country:US
Practice Address - Phone:610-921-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002476L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant