Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1194010033 |
---|---|
Provider Name | Misty Mosby |
First Address | Henderson, NV 89014-7636 |
Second Address | Henderson, NV 89014-7636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 17/06/2011 |