Provider Demographics
NPI:1225537855
Name:MOSIER, BRANDY
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:MOSIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31606 E PINK HILL RD
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-9296
Mailing Address - Country:US
Mailing Address - Phone:816-847-5006
Mailing Address - Fax:
Practice Address - Street 1:31606 E PINK HILL RD
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-9296
Practice Address - Country:US
Practice Address - Phone:816-847-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO329108235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO329108OtherDESE CERT