Individual
MICAELA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
36 E TWOHIG AVE STE 600, SAN ANGELO, TX 76903-6433
(325) 944-2561
(325) 653-4218
Mailing address
36 E TWOHIG AVE STE 600, SAN ANGELO, TX 76903-6433
(325) 944-2561
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
90329
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8.12.22
ESSENTIALS OF CBT
TX
Enumeration date
01/17/2023
Last updated
01/17/2023
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