Healthcare Provider Details

I. General information

NPI: 1003986910
Provider Name (Legal Business Name): MARGARET MOSELEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8661 LEESBURG PIKE
VIENNA VA
22182-2226
US

IV. Provider business mailing address

1631 WESTWIND WAY
MCLEAN VA
22102-1603
US

V. Phone/Fax

Practice location:
  • Phone: 703-448-5911
  • Fax:
Mailing address:
  • Phone: 703-448-5911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0019000026
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: