Individual
MRS. SHANNON L. MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, BSW, LPC, LISAC
Contact information
Practice address
1901 N TREKELL RD, CASA GRANDE, AZ 85222-1770
(520) 421-2566
(520) 421-2775
Mailing address
1657 E SUNFLOWER ST, CASA GRANDE, AZ 85222-6029
(520) 421-2566
(520) 421-2775
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-12275
AZ
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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