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General NPI Number Information
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NPI Number | 1487351318
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Entity Type | Individual
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Provider Name | WHITNEY RENAE MOSS OTA/L
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Gender | Female
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 1005 HAMPTON BLVD
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City | NORFOLK
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State | VA
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Zip | 23507-1505
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Country | US
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Telephone | 757-623-5602
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Fax |
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Provider Business Mailing Address
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Address Line | 508 PRINCE CT
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City | SUFFOLK
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State | VA
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Zip | 23434-6005
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Country | US
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Telephone | 757-621-8300
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131000363
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131000363
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License Number State | VA
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