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NPI Code Detail

MEDICARE: DEBBIE LYNN MOUSSA LCSW

MEDICARE: DEBBIE LYNN MOUSSA LCSW
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
1101YM0800XMental Health Counselor1899OR

General Provider Information

NPI Number : 1518024280
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBBIE LYNN MOUSSA LCSW
Provider Business Mailing Address
First Line : 535 SE WASHINGTON ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4142
Country : US
Telephone Number : 503-402-8617
Fax Number : 503-693-7768
Provider Business Practice Location Address
First Line : 535 SE WASHINGTON ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4142
Country : US
Telephone Number : 503-402-8617
Fax Number : 503-693-7768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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