Provider Demographics
NPI:1962645234
Name:MOSCO, ELIZABETH ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:MOSCO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9645 GATEWAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4190
Mailing Address - Country:US
Mailing Address - Phone:775-354-6371
Mailing Address - Fax:775-295-8028
Practice Address - Street 1:9645 GATEWAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4190
Practice Address - Country:US
Practice Address - Phone:775-354-6371
Practice Address - Fax:775-295-8028
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0570103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist