| NPI | 1952615965 |
|---|---|
| Former Name | MALLORY BETH MOSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO NP-5058) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN-129765) |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CO CNS-4617) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2015-04-21 |