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NPI Code Detail

MEDICARE: MARLA MOSHER

MEDICARE: MARLA MOSHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1184020513
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLA MOSHER
Provider Business Mailing Address
First Line : PO BOX 1907
Second Line :
City : PALMER
State : AK
Zip : 99645-1907
Country : US
Telephone Number : 907-745-2634
Fax Number : 907-745-4897
Provider Business Practice Location Address
First Line : 11921 E PALMER WASILLA HWY
Second Line :
City : PALMER
State : AK
Zip : 99645-8833
Country : US
Telephone Number : 907-745-2634
Fax Number : 907-745-4897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2014
Last Update Date : 11/12/2014

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Directions to “ MARLA MOSHER ” Practice Location

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