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General NPI Number Information
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NPI Number | 1245589910
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Entity Type | Individual
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Provider Name | JOSEPHINE GIANNA MOSS M.S.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 12629 STEEPLECHASE LN
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City | JACKSONVILLE
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State | FL
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Zip | 32223-3506
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Country | US
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Telephone | 904-878-1026
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Fax | 904-212-5204
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Provider Business Mailing Address
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Address Line | 12629 STEEPLECHASE LN
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City | JACKSONVILLE
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State | FL
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Zip | 32223-3506
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Country | US
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Telephone | 904-878-1026
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Fax | 904-212-5204
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2717
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT 2717
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License Number State | FL
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