Provider Demographics
NPI:1538665260
Name:MOYLE, NATALIE (CMHC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MOYLE
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9134 S PERUVIAN CIR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-2489
Mailing Address - Country:US
Mailing Address - Phone:801-509-8448
Mailing Address - Fax:
Practice Address - Street 1:9134 S PERUVIAN CIR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-2489
Practice Address - Country:US
Practice Address - Phone:801-509-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7446931-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health