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Individual

MS. LADANE JERNELL MOSELY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS OTRL

Contact information

Practice address
2900 CHARLEVOIX DR SE, SUITE 200, GRAND RAPIDS, MI 49546-7085
(800) 684-8049
Mailing address
5505 HIGHGATE DR, BALTIMORE, MD 21215-4715
(443) 520-2273

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05398
MD

Other

Enumeration date
02/24/2007
Last updated
07/08/2007
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