Individual
MRS. MIRANDA R MOSELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
2205 E 70TH ST, SUITE 102, SHREVEPORT, LA 71105
(318) 795-3388
(318) 795-3399
Mailing address
1041 EDGEFIELD DR, SHREVEPORT, LA 71118
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12338
LA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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