Provider Demographics
NPI:1477929842
Name:MOSS, VALERIE W (MSOTR/L)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:W
Last Name:MOSS
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:WESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:20 COUNTY ROAD 199
Mailing Address - Street 2:
Mailing Address - City:STRINGER
Mailing Address - State:MS
Mailing Address - Zip Code:39481-4256
Mailing Address - Country:US
Mailing Address - Phone:251-554-9920
Mailing Address - Fax:
Practice Address - Street 1:20 COUNTY ROAD 199
Practice Address - Street 2:
Practice Address - City:STRINGER
Practice Address - State:MS
Practice Address - Zip Code:39481-4256
Practice Address - Country:US
Practice Address - Phone:251-554-9920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT3278225X00000X
AL3429225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist