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General NPI Number Information
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NPI Number | 1477925857
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Entity Type | Individual
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Provider Name | KATIE LEE MOSELEY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 810 N CONNECTICUT AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-2038
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Country | US
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Telephone | 248-770-7295
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Fax |
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Provider Business Mailing Address
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Address Line | 810 N CONNECTICUT AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-2038
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Country | US
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Telephone | 248-770-7295
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010001033
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License Number State | DC
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