Provider Demographics
NPI:1578936969
Name:MOSLEY, BRENDA
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:MOSLEY
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 1:30810 LEGENDS TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3884
Mailing Address - Country:US
Mailing Address - Phone:832-570-1111
Mailing Address - Fax:
Practice Address - Street 1:30810 LEGENDS TRACE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3884
Practice Address - Country:US
Practice Address - Phone:832-570-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No251B00000XAgenciesCase Management