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General NPI Number Information
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NPI Number | 1508298357
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Entity Type | Individual
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Provider Name | SHIRLEY MOXLEY MA, LPC-S
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Gender | Female
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Dates
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Enumeration Date | 08/04/2013
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Last Update Date | 08/04/2013
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Provider Practice Location Address
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Address Line | 1336 CAVENDER DR
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City | HURST
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State | TX
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Zip | 76053-4002
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Country | US
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Telephone | 972-342-6568
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Fax |
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Provider Business Mailing Address
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Address Line | 6017 MALVEY AVE
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City | FORT WORTH
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State | TX
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Zip | 76116-4638
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Country | US
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Telephone | 972-342-6568
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 61925
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License Number State | TX
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