Provider Demographics
NPI:1366110835
Name:MOSER, ELEANOR BAARS (LPC)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:BAARS
Last Name:MOSER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 W AIRPORT FWY STE 244
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5958
Mailing Address - Country:US
Mailing Address - Phone:214-213-1053
Mailing Address - Fax:
Practice Address - Street 1:4425 W AIRPORT FWY STE 244
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5958
Practice Address - Country:US
Practice Address - Phone:214-213-1053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional