Individual
ALEXANDRA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(312) 733-0883
Mailing address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(312) 733-0883
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-133120
IL
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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