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Individual

MEHRY LYN MOSES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CLS

Contact information

Practice address
1816 E WHITTON AVE, PHOENIX, AZ 85016-6416
(928) 380-8641
Mailing address
1816 E WHITTON AVE, PHOENIX, AZ 85016-6416
(928) 380-8641

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
347C00000X
Private Vehicle
376J00000X
Homemaker
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
09/22/2020
Last updated
09/22/2020
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