Individual
ETHEL MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 SAINT ANNS AVE, BRONX, NY 10456-7885
(718) 915-6443
Mailing address
2751 BARKER AVE, BRONX, NY 10467-7350
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
03/02/2018
Last updated
08/03/2021
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