Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 3409 | AL |
NPI | 1003285578 |
---|---|
Provider Name | Jillian Mosley |
First Address | Vestavia, AL 35242-2584 |
Second Address | Mobile, AL 36695-4614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 17/06/2020 |