Provider Demographics
NPI:1588913784
Name:MOSLEY, DANIELLE RENEE PIRTLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:RENEE PIRTLE
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:RENEE
Other - Last Name:PIRTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2821 N BALLAS RD STE 265
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2380
Mailing Address - Country:US
Mailing Address - Phone:314-293-4300
Mailing Address - Fax:
Practice Address - Street 1:2821 N BALLAS RD STE 265
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2380
Practice Address - Country:US
Practice Address - Phone:314-293-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013032499103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist