Individual
MICHELE LEE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
455 N 3RD ST STE 200, PHOENIX, AZ 85004-3932
(602) 528-3450
Mailing address
1990 MCCULLOCH BLVD N # D-104, LAKE HAVASU CITY, AZ 86403-5749
(928) 566-9933
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3327
AZ
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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