Individual
CONSUELO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
640 NE 124TH ST, NORTH MIAMI, FL 33161-5523
(305) 891-4114
Mailing address
640 NE 124TH ST, NORTH MIAMI, FL 33161-5523
(305) 891-4114
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW11443
FL
Other
Enumeration date
06/16/2013
Last updated
06/16/2013
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