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NPI Code Detail

MEDICARE: ASHLEY ELIZABETH MOSER LMFT

MEDICARE: ASHLEY ELIZABETH MOSER LMFT
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
1106H00000XMarriage & Family Therapist1571NC
2106H00000XMarriage & Family Therapist166.000854IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11571OTHERNCLMFT

General Provider Information

NPI Number : 1386915742
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY ELIZABETH MOSER LMFT
Provider Business Mailing Address
First Line : 6633 FAIRVIEW RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3321
Country : US
Telephone Number : 704-366-1264
Fax Number : 704-442-4162
Provider Business Practice Location Address
First Line : 6633 FAIRVIEW RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3321
Country : US
Telephone Number : 704-366-1264
Fax Number : 704-442-4162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2012
Last Update Date : 07/10/2020

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