Provider Demographics
NPI:1972768950
Name:MOYLE, EMILY G (MSW/LSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:MOYLE
Suffix:
Gender:F
Credentials:MSW/LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 PROSPECT HILL CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-3294
Mailing Address - Country:US
Mailing Address - Phone:702-561-3999
Mailing Address - Fax:
Practice Address - Street 1:4477 PROSPECT HILL CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-3294
Practice Address - Country:US
Practice Address - Phone:702-561-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-5431041C0700X
NV2782-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker