Provider Demographics
NPI:1013277193
Name:MORA, ARIANA P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:P
Last Name:MORA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 AMELIA EARHART CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3534
Mailing Address - Country:US
Mailing Address - Phone:702-321-9863
Mailing Address - Fax:702-896-2438
Practice Address - Street 1:6600 AMELIA EARHART CT
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3534
Practice Address - Country:US
Practice Address - Phone:702-321-9863
Practice Address - Fax:702-896-2438
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0652103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent