Healthcare Provider Details

I. General information

NPI: 1902700610
Provider Name (Legal Business Name): AMARAINI S MOYA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US

IV. Provider business mailing address

11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US

V. Phone/Fax

Practice location:
  • Phone: 702-661-7436
  • Fax: 702-552-7138
Mailing address:
  • Phone: 702-661-7436
  • Fax: 702-552-7138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: