Individual
EVELINA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 1ST AVE, SCOTTSBLUFF, NE 69361-3106
(308) 635-1488
(308) 635-7880
Mailing address
1509 1ST AVENUE, SCOTTSBLUFF, NE 69361
(308) 635-1488
(308) 635-7880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-1621
NE
251B00000X
Case Management Agency
—
NE
Other
Enumeration date
03/31/2016
Last updated
09/20/2018
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