MEDICARE: MRS. ERIN MORESCHI

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	103K00000X	Behavior Analyst	ABALBA00225401	KY

General Provider Information

NPI Number	:	1528415700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN MORESCHI

Provider Business Mailing Address
First Line	:	807 SANDNESS CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40243-1729
Country	:	US
Telephone Number	:	502-386-7753
Fax Number	:	606-677-0412

Provider Business Practice Location Address
First Line	:	807 SANDNESS CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40243-1729
Country	:	US
Telephone Number	:	502-386-7753
Fax Number	:	606-677-0412

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

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/18/2016

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