| NPI | 1104459973 |
|---|---|
| Former Name | INGRID ROXANA MEJIA DE MORENO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ 16752) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 107494) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2024-10-04 |