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General NPI Number Information
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NPI Number | 1710807110
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Entity Type | Individual
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Provider Name | ISABELA MORENO
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Gender |
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 1832 E AUBURN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4884
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Country | US
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Telephone | 248-852-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 5106 SKYLITE LN
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-1652
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501016774
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License Number State | MI
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