Individual provider · NPI-1

Dr. Randy K Moss, Ph.D.

Psychologist, Counseling · Kaysville, UT

NPI number1134586654

StatusActive

Last updated in NPPESJan 28, 2016

Details

NPI: 1134586654
Entity type: Individual (NPI-1)
Name: Dr. Randy K Moss
Credential: Ph.D.
Sex: Male
Sole proprietor: No
Enumeration date: Jan 28, 2016
Last updated: Jan 28, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103TC1900X	Psychologist, Counseling	–	–	Yes
103TA0400X	Psychologist, Addiction (Substance Use Disorder)	–	–
103TB0200X	Psychologist, Cognitive & Behavioral	–	–

Practice location

447 N 300 W
Kaysville, UT 84037-4203

Phone 907-232-5374 · Fax 801-544-3819

Mailing address

4589 Ranch Blvd
Mountain Green, UT 84050-5515

Phone 907-232-5374 · Fax 801-544-3819

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