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General NPI Number Information
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NPI Number | 1790805463
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Entity Type | Individual
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Provider Name | TAMELA LYNN MOSS MA, LPA
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1429 E MARION ST STE 5
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City | SHELBY
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State | NC
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Zip | 28150-4946
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Country | US
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Telephone | 704-480-5400
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Fax | 704-480-5477
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Provider Business Mailing Address
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Address Line | 909 MARYS GROVE RD
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City | CHERRYVILLE
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State | NC
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Zip | 28021-9615
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Country | US
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Telephone | 704-472-7497
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 1911
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License Number State | NC
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