Individual
ALYSSA JADE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 COORS BLVD NW, ALBUQUERQUE, NM 87120-1173
(505) 788-6770
Mailing address
2929 COORS BLVD NW, ALBUQUERQUE, NM 87120-1173
(505) 788-6770
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
12/04/2024
Last updated
12/09/2024
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