Healthcare Provider Details

I. General information

NPI: 1477929842
Provider Name (Legal Business Name): VALERIE W MOSS M.S.OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE WESTON M.S.OTR/L

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 12/23/2020
Certification Date: 12/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COUNTY ROAD 199
STRINGER MS
39481-4256
US

IV. Provider business mailing address

20 COUNTY ROAD 199
STRINGER MS
39481-4256
US

V. Phone/Fax

Practice location:
  • Phone: 251-554-9920
  • Fax:
Mailing address:
  • Phone: 251-554-9920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3278
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3429
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: