Healthcare Provider Details

I. General information

NPI: 1700727997
Provider Name (Legal Business Name): HEATHER MOXLEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 34TH AVE
VERO BEACH FL
32960-3841
US

IV. Provider business mailing address

1206 34TH AVE
VERO BEACH FL
32960-3841
US

V. Phone/Fax

Practice location:
  • Phone: 772-563-8855
  • Fax:
Mailing address:
  • Phone: 772-563-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER J MOXLEY
Title or Position: OWNER/AGENT/MANAGER
Credential:
Phone: 772-563-8855