Organization
MORENO THERAPY P.C., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE RAY MORENO LIMHP (FOUNDER)
(402) 660-9555
Entity
Organization
Contact information
Practice address
2620 N 132ND AVE, OMAHA, NE 68164-4023
(402) 660-9555
Mailing address
2620 N 132ND AVE, OMAHA, NE 68164-4023
(402) 660-9555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790238665
—
NE
Enumeration date
05/12/2020
Last updated
11/14/2024
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