Provider Demographics
NPI:1588077341
Name:MOSIER, PATRICIA ANN (SLP-CCC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MOSIER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16534 COUNTY ROAD 164
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:TX
Mailing Address - Zip Code:77861-4409
Mailing Address - Country:US
Mailing Address - Phone:936-394-2162
Mailing Address - Fax:
Practice Address - Street 1:16534 COUNTY ROAD 164
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:TX
Practice Address - Zip Code:77861-4409
Practice Address - Country:US
Practice Address - Phone:936-697-4506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist