Individual
KRISTA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
950 MALABAR RD SW # 111469, PALM BAY, FL 32907-6834
(954) 651-8827
Mailing address
PO BOX 111469, PALM BAY, FL 32911
(954) 651-8827
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT3238
FL
Other
Enumeration date
01/03/2020
Last updated
09/13/2021
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