Provider Demographics
NPI:1992684666
Name:MOORE, EMILY NOELLE (OTD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NOELLE
Last Name:MOORE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 GREENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713
Mailing Address - Country:US
Mailing Address - Phone:479-795-1260
Mailing Address - Fax:479-795-1261
Practice Address - Street 1:1601 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713
Practice Address - Country:US
Practice Address - Phone:479-795-1260
Practice Address - Fax:479-795-1261
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics