Individual
MRS. JESSICA NICOLE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 522-4004
(575) 522-9017
Mailing address
1320 S SOLANO DR, LAS CRUCES, NM 88001-3758
(575) 522-4004
(575) 522-9017
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-07157
NM
1041C0700X
Clinical Social Worker
Primary
I-07761
NM
Other
Enumeration date
03/03/2010
Last updated
10/17/2011
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