Healthcare Provider Details

I. General information

NPI: 1730964172
Provider Name (Legal Business Name): MOYA MENTAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 01/21/2024
Certification Date: 01/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N HAYDEN RD STE 103
SCOTTSDALE AZ
85257-2326
US

IV. Provider business mailing address

PO BOX 44854
PHOENIX AZ
85064-4854
US

V. Phone/Fax

Practice location:
  • Phone: 980-335-8094
  • Fax:
Mailing address:
  • Phone: 980-335-8094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. NYANYIWA VIMBA
Title or Position: MENTAL HEALTH PROVIDER/OWNER
Credential: PMHNP
Phone: 480-810-3009