Individual
MADELEINE RACHELLE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP- BC (CRNP
Contact information
Practice address
750 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7456
(205) 348-6262
Mailing address
PO BOX 870360, TUSCALOOSA, AL 35487-5309
(205) 348-6262
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
1-052771
AL
2084P0800X
Psychiatry Physician
Primary
1052771
AL
Other
Enumeration date
07/28/2006
Last updated
10/24/2023
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