Provider Demographics
NPI:1982846978
Name:MOSSER, STEPHEN (BCABA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:MOSSER
Suffix:
Gender:M
Credentials:BCABA
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 1081
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1081
Mailing Address - Country:US
Mailing Address - Phone:727-403-1318
Mailing Address - Fax:
Practice Address - Street 1:1837 BOUGH AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-1558
Practice Address - Country:US
Practice Address - Phone:727-403-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-02-0601103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst