Basic Information
| Provider Information | |||||||||
| NPI: | 1245323070 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOSER | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 KELLER WAY | ||||||||
| Address2: | |||||||||
| City: | DOWNINGTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102698159 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 BLACK HORSE HILL ROAD | ||||||||
| Address2: | V A MEDICAL CENTER | ||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
| FaxNumber: | 6103804337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW122572 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.