Individual
RACHEL ELIZABETH MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8333 COUNTY ROAD 381, TYLER, TX 75708-5733
(903) 570-2814
Mailing address
13296 FM 16 E, WINONA, TX 75792-5308
(903) 570-2814
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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