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Organization
SALLY K. MOSELEY, LPC, P.A.
Active
Organization
SALLY K. MOSELEY, LPC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY K MOSELEY LPC (OWNER)
(903) 297-4592
Entity
Organization
Contact information
Practice address
1800 W LOOP 281, SUITE 207, LONGVIEW, TX 75604-2568
(903) 297-4592
Mailing address
1800 W LOOP 281, SUITE 207, LONGVIEW, TX 75604-2568
(903) 297-4592
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
14242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028712001
—
TX
01
—
1013006113
NPI INDIVIDUAL
—
01
—
19GT
BLUE CROSS BLUE SHIELD
TX
01
—
84049L
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/04/2007
Last updated
06/03/2008
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