Moffett, Ieisha

Moffett, Ieisha is an sole proprietor health care provider with primary practice located at 1100 W 6Th Ave , Gary IN 46402-1711. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as her primary health care specialty. Moffett, Ieisha can be contacted via phone (219) 885-4264.

Contact Information

Primary practice address
1100 W 6Th Ave Gary IN 46402-1711
Phone: (219) 885-4264
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X

Profile Details

NPI number 1366816084
LBN Legal business name Moffett, Ieisha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2015
Last updated Nov 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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