Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW3423 | FL |
NPI | 1003029042 |
---|---|
Provider Name | Mrs. Paula F Moser |
First Address | Lake City, FL 32055 |
Second Address | Lake City, FL 32055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |