Provider Demographics
NPI:1356937551
Name:MOSS, VELMA LOUISE
Entity type:Individual
Prefix:
First Name:VELMA
Middle Name:LOUISE
Last Name:MOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21021 ALDINE WESTFIELD RD APT 11201
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3638
Mailing Address - Country:US
Mailing Address - Phone:281-798-5928
Mailing Address - Fax:
Practice Address - Street 1:21021 ALDINE WESTFIELD RD APT 11201
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3638
Practice Address - Country:US
Practice Address - Phone:281-798-5928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional