Doctor Name: | NATHALYE CAROLINA MORENO |
NPI Number: | 1023449501 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BS |
License Number: | |
Business Practice Address: | 515 28 3/4 Rd Grand Junction, CO - 815015016 |
Business Phone Number: | 9706837107 |
Business Fax Number: | 9706837167 |
Mailing Address: | 715 Horizon Dr, Ste 225 GRAND JUNCTION |
State: | CO |
Postal Code: | 815068700 |
Phone Number: | 9706837107 |
Fax Number: | 9706837167 |
NPI Enumeration Date: | 12/09/2013 |
NPI Last Update Date: | 01/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |