Individual
STEPHANIE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
376 E APPLE AVE, MUSKEGON, MI 49442-3466
(616) 742-6050
Mailing address
376 E APPLE AVE, MUSKEGON, MI 49442-3466
(231) 724-6050
(231) 724-6066
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361003075
MI
103TC1900X
Counseling Psychologist
6301016365
MI
Other
Enumeration date
12/02/2015
Last updated
10/16/2020
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