Healthcare Provider Details

I. General information

NPI: 1558705913
Provider Name (Legal Business Name): CORTNEY J MOSLE MS. OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11804 BEEKMAN PL
ROCKVILLE MD
20854-2177
US

IV. Provider business mailing address

PO BOX 59103
POTOMAC MD
20859-9103
US

V. Phone/Fax

Practice location:
  • Phone: 410-937-9579
  • Fax:
Mailing address:
  • Phone: 410-937-9579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number07133
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number07133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: