| NPI | 1689803082 |
|---|---|
| Former Name | JULISSA MARY MORENO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080607) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 079178) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2023-12-13 |