| NPI | 1083392674 |
|---|---|
| Former Name | ROSA TATIANA MORENO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19817-130) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 134960-121) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-11-14 |