Provider Demographics
NPI:1942577655
Name:MOSS, BETTY MARIE (MS,CCC/A)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:MARIE
Last Name:MOSS
Suffix:
Gender:F
Credentials:MS,CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19405 EMERALD SQ
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3637
Mailing Address - Country:US
Mailing Address - Phone:301-745-4820
Mailing Address - Fax:
Practice Address - Street 1:19405 EMERALD SQ
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3637
Practice Address - Country:US
Practice Address - Phone:301-745-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0596237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter