| Organization Name: | WILLIAM A. MOSS, PSY.D., LLC |
| NPI Number: | 1033255146 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM A MOSS (PROPRIETOR) |
| Mailing Address: | 3601 Canyon Lake Dr Rapid City |
| State: | SD US |
| Postal Code: | 577023900 |
| Phone Number: | 6053418647 |
| Fax Number: | 6053410489 |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 416 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |