Individual
MRS. EDNA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS SLP
Contact information
Practice address
4301 E LYNNE LN, PHOENIX, AZ 85042-5255
(602) 284-1657
Mailing address
4301 E LYNNE LN, PHOENIX, AZ 85042-5255
(602) 284-1657
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL5122
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134804
—
AZ
Enumeration date
02/01/2007
Last updated
07/09/2007
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