Individual
MRS. KERI BETH MOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
9653 CONSTELLATION BLVD, APT 11210, FORT WORTH, TX 76108-7648
(662) 719-3774
Mailing address
9653 CONSTELLATION BLVD, APT 11210, FORT WORTH, TX 76108-7648
(662) 719-3774
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
112790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLIED FOR
BCBS
MS
05
—
APPLIED FOR
—
MS
Enumeration date
05/14/2007
Last updated
04/17/2009
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