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General NPI Number Information
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NPI Number | 1235092339
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Entity Type | Individual
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Provider Name | KRISTEN MOYER PTA
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Gender | Female
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 354 MOUNTAIN RD STE E
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City | PASADENA
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State | MD
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Zip | 21122-1158
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Country | US
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Telephone | 410-360-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 CREEKLAND CT
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City | STONEY BEACH
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State | MD
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Zip | 21226-2122
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Country | US
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Telephone | 443-623-3655
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A2983
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License Number State | MD
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