Maryalice Moulder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

J2-0000142 Issued in DE

Practice address

37513 Bay Harbor Dr
Rehoboth Beach, DE 19971-1584

Phone

(302) 367-6699

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1083950786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37513 BAY HARBOR DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199711584",
            "telephone_number": "302-367-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37513 BAY HARBOR DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199711584",
            "telephone_number": "302-367-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "MARYALICE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DE",
            "license": "J2-0000142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Map Wellness LLC
• Mindful Psychotherapeutics
• Dean L Mittman, MD
• Carmel Monfiletto, MS,RD,LDN
• Shelby Moore, OT
• Sarah Katherine Murphy, NP
• Ty Murphy
• Srujitha Murukutla, M.D.
• MX Physical Therapy, Inc.
• Nai Saturn Eastern LLC

• Physical Therapy Assistant in Rehoboth Beach, DE
• Providers in Rehoboth Beach, DE by specialty
• Physical Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.