Individual
ETHAN MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4444 CORONA DR, STE. 234, CORPUS CHRISTI, TX 78411-4324
(361) 854-1110
(855) 448-9769
Mailing address
4444 CORONA DR, STE. 234, CORPUS CHRISTI, TX 78411-4324
(361) 854-1110
(855) 448-9769
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
38714
TX
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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