Provider Demographics
NPI:1316148042
Name:MOSELEY, MARGIE REE
Entity type:Individual
Prefix:MS
First Name:MARGIE
Middle Name:REE
Last Name:MOSELEY
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 1:901 N PACIFIC COAST HWY
Mailing Address - Street 2:STE 200A-204A
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2162
Mailing Address - Country:US
Mailing Address - Phone:310-316-1610
Mailing Address - Fax:310-316-4209
Practice Address - Street 1:901 N PACIFIC COAST HWY
Practice Address - Street 2:STE 200A-204A
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2162
Practice Address - Country:US
Practice Address - Phone:310-316-1610
Practice Address - Fax:310-316-4209
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist