Provider Demographics
NPI:1649501784
Name:MOSLEY, CHARMANIKA KESONA (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:CHARMANIKA
Middle Name:KESONA
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:MS
Other - First Name:CHARMANIKA
Other - Middle Name:KESONA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2059 GOVERT DR
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-5126
Mailing Address - Country:US
Mailing Address - Phone:708-679-4349
Mailing Address - Fax:
Practice Address - Street 1:2059 GOVERT DR
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-5126
Practice Address - Country:US
Practice Address - Phone:708-679-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10114940103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool