Individual
DR. DESIREE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DAT, LAT, ATC
Contact information
Practice address
1356 VISTA PL, RATON, NM 87740-2221
(715) 554-2728
Mailing address
723 W JEFFERSON ST, TRINIDAD, CO 81082-3667
(719) 557-0570
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1454-39
WI
2255A2300X
Athletic Trainer
Primary
AT.0001395
CO
2255A2300X
Athletic Trainer
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Other
Enumeration date
12/17/2015
Last updated
05/22/2024
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