| Doctor Name: | MRS. NICOLE LANELL MOSE |
| NPI Number: | 1356634190 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LGSW |
| License Number: | 1777G |
| Business Practice Address: | 2400 Hospital Rd Tuskegee, AL - 360835001 |
| Business Phone Number: | 3347270550 |
| Business Fax Number: | 3347252776 |
| Mailing Address: | 6920 Oak Side Dr, MONTGOMERY |
| State: | AL |
| Postal Code: | 361177609 |
| Phone Number: | 3347270550 |
| Fax Number: | 3347252776 |
| NPI Enumeration Date: | 05/26/2011 |
| NPI Last Update Date: | 05/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1777G |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |