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General NPI Number Information
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NPI Number | 1679873244
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Entity Type | Organization
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Legal Business Name | MOSSEY PSYCHOLOGICAL SERVICES PA
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 218 ARBOR WOODS CIR
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City | OLDSMAR
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State | FL
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Zip | 34677-4655
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Country | US
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Telephone | 727-501-3666
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Fax | 813-855-4029
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Provider Business Mailing Address
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Address Line | 36181 E LAKE RD 264
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City | PALM HARBOR
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State | FL
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Zip | 34685-3142
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Country | US
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Telephone | 727-501-3666
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Fax | 727-787-8170
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JONATHAN C MOSSEY
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Credential | PSYD
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Telephone | 727-501-3666
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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 | PY7087
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License Number State | FL
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