Individual
DONALD MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7010 E BOGARD RD, WASILLA, AK 99654-4711
(907) 677-6467
Mailing address
7010 E BOGARD RD, WASILLA, AK 99654-4711
(352) 874-5104
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
10/01/2025
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