Individual
MICHAELA AMARIS MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 SWEET CHERRY LN, SUMMERVILLE, SC 29486-8135
(650) 444-4654
Mailing address
144 SWEET CHERRY LN, SUMMERVILLE, SC 29486-8135
(650) 444-4654
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-23252517
RI
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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