Provider Demographics
NPI:1750863270
Name:MORENO, NORIESSA A (SLP-CF)
Entity Type:Individual
Prefix:
First Name:NORIESSA
Middle Name:A
Last Name:MORENO
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 CARAVEL ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5841
Mailing Address - Country:US
Mailing Address - Phone:210-381-2231
Mailing Address - Fax:
Practice Address - Street 1:22211 W IH 10 STE 1206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1742
Practice Address - Country:US
Practice Address - Phone:210-888-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist