Provider Demographics
NPI:1588087464
Name:MOSLEY, DANIELLE P
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:P
Last Name:MOSLEY
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 1:1026 SUTHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1247
Mailing Address - Country:US
Mailing Address - Phone:330-880-7292
Mailing Address - Fax:
Practice Address - Street 1:1026 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1247
Practice Address - Country:US
Practice Address - Phone:330-880-7292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0084322Medicaid