Individual
EVA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(360) 224-4041
Mailing address
11545 E SILICA DR, KINGMAN, AZ 86401-8569
(360) 224-4041
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-21825
AZ
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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