Individual
DR. DESIRAE ANGELA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
121 S WHITTIER RD, WICHITA, KS 67207-1064
(316) 617-0357
Mailing address
14508 W PRICE ST, WICHITA, KS 67235-1600
(316) 617-0357
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1341
KS
103TC0700X
Clinical Psychologist
2090
KS
103TC0700X
Clinical Psychologist
Primary
2287
KS
Other
Enumeration date
05/19/2009
Last updated
12/25/2022
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