Individual
GLORIA LUCIA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
534 BOYER AVE, WALLA WALLA, WA 99362-2047
(509) 525-6463
(509) 522-0578
Mailing address
410 CHASE AVE, WALLA WALLA, WA 99362-2946
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
907
WA
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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