Individual
MARISOL MORENO LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
5317 W PECAN RD, LAVEEN, AZ 85339-2457
(602) 577-2086
Mailing address
5317 W PECAN RD, LAVEEN, AZ 85339-2457
(602) 577-2086
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
227283
AZ
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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