Provider Demographics
NPI:1285446187
Name:MORENO ROQUE, NIURKA (MENTAL THERAPIST)
Entity type:Individual
Prefix:
First Name:NIURKA
Middle Name:
Last Name:MORENO ROQUE
Suffix:
Gender:F
Credentials:MENTAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 NW 1ST TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-7501
Mailing Address - Country:US
Mailing Address - Phone:768-343-9882
Mailing Address - Fax:
Practice Address - Street 1:2234 NW 1ST TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-7501
Practice Address - Country:US
Practice Address - Phone:786-343-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health