Individual
MRS. MYANIA MOSES
Active
Individual
MRS. MYANIA MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0019000422
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54-1937142
VA LICENSE 519108
VA
Enumeration date
07/12/2011
Last updated
07/12/2011
Update your record
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