Individual
CALICIA JEAN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6157 GREENVALE RD, WATERTOWN, TN 37184-3812
(615) 516-7712
Mailing address
6157 GREENVALE RD, WATERTOWN, TN 37184-3812
(615) 516-7712
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6179
TN
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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