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General NPI Number Information
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NPI Number | 1346867033
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Entity Type | Individual
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Provider Name | CASEY JANNAE MOSER PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 734 IRMA AVE
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City | ORLANDO
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State | FL
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Zip | 32803-3853
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Country | US
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Telephone | 407-920-2584
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Fax |
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Provider Business Mailing Address
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Address Line | 208 BLUESTONE PL
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City | CASSELBERRY
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State | FL
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Zip | 32707-4147
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Country | US
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Telephone | 407-920-2584
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7405
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License Number State | FL
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