Provider Demographics
NPI:1326585233
Name:MORENO, ALICIA NAOMI (MSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:NAOMI
Last Name:MORENO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 4TH AVE W
Mailing Address - Street 2:9B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12600 4TH AVE W
Practice Address - Street 2:9B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5709
Practice Address - Country:US
Practice Address - Phone:425-246-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical