Individual
AILEEN MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25773 OPHIR DR, MADERA, CA 93638-0526
(559) 514-9095
Mailing address
7339 N 1ST ST STE 110, FRESNO, CA 93720-2954
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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