Individual
MR. MARCOS MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4120 N LINDER RD STE 109, MERIDIAN, ID 83646-5416
(208) 391-4841
(208) 391-4966
Mailing address
5154 N BUCKBOARD PL, BOISE, ID 83713-1871
(208) 995-3664
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-33200
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-35672
ID
Other
Enumeration date
08/10/2013
Last updated
06/12/2023
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