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Individual

BRAD B MOSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LMHC

Contact information

Practice address
6700 S FLORIDA AVE, SUITE 35, LAKELAND, FL 33813-3327
(863) 644-8241
(863) 644-9025
Mailing address
6700 S FLORIDA AVE, SUITE 35, LAKELAND, FL 33813-3327
(863) 644-8241
(863) 644-9025

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH7813
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Z064R
BLUECROSS BLUESHIELD
FL
Enumeration date
08/29/2006
Last updated
07/08/2007
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