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General NPI Number Information
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NPI Number | 1144557471
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Entity Type | Individual
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Provider Name | TYANN L. MOSLEY LPC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 3309 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63139-1101
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Country | US
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Telephone | 314-534-9350
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 MCPHERSON AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63112-1305
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Country | US
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Telephone | 314-520-8443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2009002728
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License Number State | MO
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