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General NPI Number Information
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NPI Number | 1801334420
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Entity Type | Individual
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Provider Name | MS. NERISSA MOSER
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Gender | Female
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1500 E THOMAS RD SUITE 106
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City | PHOENIX
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State | AZ
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Zip | 85014-5708
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Country | US
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Telephone | 714-474-6222
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Fax |
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Provider Business Mailing Address
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Address Line | 720 S DOBSON RD UNIT 20
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City | MESA
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State | AZ
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Zip | 85202-2747
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Country | US
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Telephone | 714-474-6222
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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 |
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License Number State |
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