MEDICARE: SUSAN MOORE VOSSELER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1225489537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MOORE VOSSELER

Provider Business Mailing Address
First Line	:	9733 SANCTUARY SQUARE DR
Second Line	:	#311
City	:	ORLANDO
State	:	FL
Zip	:	32832-6619
Country	:	US
Telephone Number	:	215-208-1970
Fax Number	:

Provider Business Practice Location Address
First Line	:	9733 SANCTUARY SQUARE DR
Second Line	:	#311
City	:	ORLANDO
State	:	FL
Zip	:	32832-6619
Country	:	US
Telephone Number	:	215-208-1970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2016
Last Update Date	:	06/28/2016

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Directions to “ SUSAN MOORE VOSSELER ” Practice Location

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