Provider Demographics
NPI:1174181275
Name:MOSELEY, ASHA MARISELLA (ATC)
Entity type:Individual
Prefix:MRS
First Name:ASHA
Middle Name:MARISELLA
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 W 38TH AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1864
Mailing Address - Country:US
Mailing Address - Phone:303-437-2561
Mailing Address - Fax:
Practice Address - Street 1:3550 W 38TH AVE APT 401
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1864
Practice Address - Country:US
Practice Address - Phone:303-437-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00019442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer