Healthcare Provider Details

I. General information

NPI: 1992627954
Provider Name (Legal Business Name): MOCA MCCARTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 OLIVE LN
GARRISON MD
21117-3901
US

IV. Provider business mailing address

39 OLIVE LN
GARRISON MD
21117-3901
US

V. Phone/Fax

Practice location:
  • Phone: 410-245-7572
  • Fax:
Mailing address:
  • Phone: 410-245-7572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM05914
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: