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NPI Code Detail

MEDICARE: MAYRA PRISSILLA MORENO RBT

MEDICARE: MAYRA PRISSILLA MORENO RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-26-511987TX

General Provider Information

NPI Number : 1144171067
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYRA PRISSILLA MORENO RBT
Provider Business Mailing Address
First Line : 991 OAK CREEK DR
Second Line :
City : LOMBARD
State : IL
Zip : 60148-6408
Country : US
Telephone Number : 847-465-9556
Fax Number :
Provider Business Practice Location Address
First Line : 700 N SAINT MARYS ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-3507
Country : US
Telephone Number : 847-465-9556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ MAYRA PRISSILLA MORENO RBT” Practice Location

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