Individual
TRICIA L MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
100 NAVARRE PL STE 4460, SOUTH BEND, IN 46601-1168
(574) 235-1010
(574) 232-2064
Mailing address
58058 WINDSOR AVE, SOUTH BEND, IN 46619-9407
(574) 298-1075
(574) 237-9383
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002162A
IN
237600000X
Audiologist-Hearing Aid Fitter
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200133740
—
IN
Enumeration date
12/21/2006
Last updated
11/28/2023
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