Provider Demographics
NPI:1336720770
Name:MOSELEY, HALLE RHIANNON
Entity Type:Individual
Prefix:
First Name:HALLE
Middle Name:RHIANNON
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANSEL
Other - Middle Name:R
Other - Last Name:MOSELEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:17124 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-7480
Mailing Address - Country:US
Mailing Address - Phone:405-694-3011
Mailing Address - Fax:
Practice Address - Street 1:17124 CEDAR LN
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-7480
Practice Address - Country:US
Practice Address - Phone:405-694-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist