Most Relevant Information
Provider Data
| NPI Number: | 1003416785 |
| Provider Name: | MARISOL MORENO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2020 |
| Last Updated: | 10/30/2020 |
Provider Practice Location
18002 IRVINE BLVD STE 202C
TUSTIN
CA
927803322
Practice Location Phone/Fax
| Phone: | 9499231733 |
| Fax: | 7142421646 |
Provider Mailing Location
18002 IRVINE BLVD STE 202C
TUSTIN
CA
927803322
Provider Mailing Phone/Fax
| Phone: | 9499231733 |
| Fax: | 7142421646 |