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General NPI Number Information
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NPI Number | 1639910102
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Entity Type | Individual
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Provider Name | TIARA MONIQUE MOSLEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 307 W MAIN ST STE 2
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-5796
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Country | US
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Telephone | 641-323-2729
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Fax | 888-920-1276
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Provider Business Mailing Address
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Address Line | 339 SAXON ST APT 2
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City | WATERLOO
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State | IA
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Zip | 50703-3842
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Country | US
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Telephone | 319-550-2567
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 123593
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License Number State | IA
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