MEDICARE: DANESHIA MOTEN

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	106H00000X	Marriage & Family Therapist	205574	TX

General Provider Information

NPI Number	:	1982421293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANESHIA MOTEN

Provider Business Mailing Address
First Line	:	7913 PEBBLEBROOK DR
Second Line	:
City	:	WATAUGA
State	:	TX
Zip	:	76148-1520
Country	:	US
Telephone Number	:	314-699-7050
Fax Number	:

Provider Business Practice Location Address
First Line	:	9285 HUNTINGTON SQ STE D
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-4319
Country	:	US
Telephone Number	:	314-699-7050
Fax Number	:

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

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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Directions to “ DANESHIA MOTEN ” Practice Location

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