MEDICARE: KENDAL MOSS

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1881542991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDAL MOSS

Provider Business Mailing Address
First Line	:	2350 RACE TRACK RD
Second Line	:
City	:	SOPHIA
State	:	NC
Zip	:	27350-8901
Country	:	US
Telephone Number	:	336-225-1841
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 MADISON ST
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-3146
Country	:	US
Telephone Number	:	336-880-4040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ KENDAL MOSS ” Practice Location

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