Individual ProviderMiranda R MoseleyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2205 E 70th St, Suite 102, Shreveport, LA 71105(318) 795-3388PECOS EnrollmentBased on the most recent information from CMS, provider Miranda R Moseley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1720197627Provider TypeIndividualFull NameMoseley, Miranda RTitleMrs.CredentialLOTRGenderFemaleSole ProprietorNoEnumeration Date8/30/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address2205 E 70th St, Suite 102, Shreveport, LA 71105Phone(318) 795-3388Fax(318) 795-3399Mailing LocationMailing Address1041 Edgefield Dr, Shreveport, LA 71118PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseZ12338Louisiana