MEDICARE: DR. DANIELLE MOREGGI PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	002497	CT
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	PY0742	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215147673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE MOREGGI PH.D.

Provider Business Mailing Address
First Line	:	2451 S BUFFALO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2749
Country	:	US
Telephone Number	:	702-546-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 S BUFFALO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2749
Country	:	US
Telephone Number	:	702-546-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	10/02/2023

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