Provider Demographics
NPI:1396984647
Name:MOSEL, RENEE J (PARA-PROFESSIONAL)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:J
Last Name:MOSEL
Suffix:
Gender:F
Credentials:PARA-PROFESSIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45012 W HONEYCUTT AVE
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239-2842
Mailing Address - Country:US
Mailing Address - Phone:520-568-8100
Mailing Address - Fax:520-568-8119
Practice Address - Street 1:45012 W HONEYCUTT AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239-2842
Practice Address - Country:US
Practice Address - Phone:520-568-8100
Practice Address - Fax:520-568-8119
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPARA-PROFESSIONAL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist