Individual
MR. JEFF RYAN MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
923 16TH AVE S, NAMPA, ID 83651-4731
(208) 639-1514
(208) 639-2301
Mailing address
923 16TH AVE S, NAMPA, ID 83651-4731
(208) 639-1514
(208) 639-2301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-31828
ID
Other
Enumeration date
12/29/2011
Last updated
07/20/2023
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