| Doctor Name: | MARTINA GINA MOSS |
| NPI Number: | 1174942288 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADCI |
| License Number: | 01386 |
| Business Practice Address: | 1080 S. Hwy 95a Unit D Silver Springs, NV - 89429 |
| Business Phone Number: | 7755774633 |
| Business Fax Number: | 7755779937 |
| Mailing Address: | 720 S. Main St., Suite C YERINGTON |
| State: | NV |
| Postal Code: | 89447 |
| Phone Number: | 7754636597 |
| Fax Number: | 7754636598 |
| NPI Enumeration Date: | 04/16/2014 |
| NPI Last Update Date: | 04/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 01386 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |