Individual
DIVINA JANE MORALEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13481 W MCDOWELL RD STE 400, GOODYEAR, AZ 85395-2725
(623) 471-5586
Mailing address
5793 N 72ND DR, GLENDALE, AZ 85303-4747
(480) 875-5295
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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