Individual
COLEEN C. MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LICSW
Contact information
Practice address
1620 E 12TH ST, THE DALLES, OR 97058
(541) 296-9151
Mailing address
1620 E 12TH ST, THE DALLES, OR 97058-3213
(541) 296-9151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5249
OR
Other
Enumeration date
01/15/2014
Last updated
01/23/2019
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