Female

Melissa I. Moose LC SW

Clinical Social Worker in Shelby, NC(View on Map)

Full Name

Melissa I Moose LC SW

NPI Number

1245276385

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/20/2006

Specialties

(Taxonomies)

Code

1041C0700X

Primary Taxonomy

Yes

Licenses

State

North Carolina

License Number

C004426

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 4003
917 1ST ST

City

Gastonia
Shelby

State

NC
NC

Postal Code

28054-0020
28150-3958

Country

US
US

Telephone Number

(704) 865-3525
(704) 476-4028

Identifiers

Identifier

6106324
14219
188636

Identifier State

NC
NC
NC

Identifier Issuer

Unknown
BCBS
MEDCOST

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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