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Individual
BEVERLY MORENO
Active
Individual
BEVERLY MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111750
TDLR SLP LICENSE
TX
01
—
14225877
ASHA CCC-SLP CERTIFICATION
—
Enumeration date
08/03/2022
Last updated
08/03/2022
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