Doctor Name: | ANN MARIE MORENO |
NPI Number: | 1164508081 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 05875 |
Business Practice Address: | 317 Godwin Ave Midland Park, NJ - 074321519 |
Business Phone Number: | 2014450717 |
Business Fax Number: | 2014471240 |
Mailing Address: | 16 Judith Ann Ct, MAHWAH |
State: | NJ |
Postal Code: | 074301411 |
Phone Number: | 2015292202 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 05875 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |