Provider Demographics
NPI:1144808205
Name:MOSSEL, DIANN
Entity type:Individual
Prefix:
First Name:DIANN
Middle Name:
Last Name:MOSSEL
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 1:900 BUFFALO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1206
Mailing Address - Country:US
Mailing Address - Phone:570-523-6787
Mailing Address - Fax:
Practice Address - Street 1:900 BUFFALO RD STE 1
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1206
Practice Address - Country:US
Practice Address - Phone:570-523-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician