Provider Demographics
NPI:1861691164
Name:MOSHER, KATHRYN ROSE (LCP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ROSE
Last Name:MOSHER
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SW FRAZIER AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1963
Mailing Address - Country:US
Mailing Address - Phone:785-232-5005
Mailing Address - Fax:
Practice Address - Street 1:809 ELMHURST BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7405
Practice Address - Country:US
Practice Address - Phone:857-823-6322
Practice Address - Fax:785-823-3109
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist