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Individual
MS. STEFANIE MORENO
Active
Individual
MS. STEFANIE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009261
VA
1041C0700X
Clinical Social Worker
11589
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13833970
CAQH
VA
Enumeration date
10/06/2016
Last updated
08/20/2018
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