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General NPI Number Information
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NPI Number | 1134060130
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Entity Type | Individual
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Provider Name | KEYLA MORENO
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Gender |
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 565 LAKEVIEW PKWY
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City | VERNON HILLS
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State | IL
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Zip | 60061-1857
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Country | US
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Telephone | 877-466-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 20740 N HORATIO BLVD
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City | PRAIRIE VIEW
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State | IL
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Zip | 60069-9651
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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