Provider Demographics
NPI:1730813031
Name:MOSER, MONICA (SCMT, MT-BC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MOSER
Suffix:
Gender:F
Credentials:SCMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 S MORYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2410
Mailing Address - Country:US
Mailing Address - Phone:385-228-3555
Mailing Address - Fax:
Practice Address - Street 1:9192 S 300 W STE 27A
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2634
Practice Address - Country:US
Practice Address - Phone:801-200-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13560225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist