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NPI Code Detail

MEDICARE: DR. DANIELLE RENEE PIRTLE MOSLEY PSYD

MEDICARE: DR. DANIELLE RENEE PIRTLE MOSLEY PSYD
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
1103T00000XPsychologist2013032499MO

General Provider Information

NPI Number : 1588913784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE RENEE PIRTLE MOSLEY PSYD
Provider Business Mailing Address
First Line : 2821 N BALLAS RD STE 265
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63131-2380
Country : US
Telephone Number : 314-293-4300
Fax Number :
Provider Business Practice Location Address
First Line : 2821 N BALLAS RD STE 265
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63131-2380
Country : US
Telephone Number : 314-293-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2012
Last Update Date : 11/16/2023

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