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NPI Code Detail

MEDICARE: CLARISSA MOSELY

MEDICARE: CLARISSA MOSELY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1629923941
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARISSA MOSELY
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 5281 FOUNTAIN DR
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-1122
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ CLARISSA MOSELY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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