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NPI Code Detail

MEDICARE: DESIREE MOSS

MEDICARE: DESIREE MOSS
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
1225400000XRehabilitation Practitioner
2101YA0400XAddiction (Substance Use Disorder) Counselor07840-INV

General Provider Information

NPI Number : 1386032464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE MOSS
Provider Business Mailing Address
First Line : 3441 W SAHARA AVE STE C1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-6059
Country : US
Telephone Number : 702-445-7318
Fax Number :
Provider Business Practice Location Address
First Line : 3441 W SAHARA AVE STE C1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-6059
Country : US
Telephone Number : 702-445-7318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/25/2014
Last Update Date : 07/22/2025

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Directions to “ DESIREE MOSS ” Practice Location

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