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Individual

MARCILENA GABRIELLE MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
302 RAILWAY AVE., SEWARD, AK 99664
(907) 224-5257
Mailing address
32981 MYRTLEWOOD CIR, SEWARD, AK 99664-9649
(417) 429-7471

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
AK

Other

Enumeration date
02/23/2022
Last updated
02/23/2022
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