Individual
LUPITA ADALI MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A CCC/SLP
Contact information
Practice address
1500 SW 104TH ST STE 2, OKLAHOMA CITY, OK 73159-7661
(405) 395-7203
Mailing address
1500 SW 104TH ST STE 2, OKLAHOMA CITY, OK 73159-7661
(405) 395-7203
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4150
OK
Other
Enumeration date
10/03/2013
Last updated
03/02/2015
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