Provider Demographics
NPI:1306563655
Name:MORENO, YAEL (LMFT)
Entity type:Individual
Prefix:
First Name:YAEL
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19400 TURNBERRY WAY APT 622
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2691
Mailing Address - Country:US
Mailing Address - Phone:954-288-0147
Mailing Address - Fax:
Practice Address - Street 1:19400 TURNBERRY WAY APT 622
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2691
Practice Address - Country:US
Practice Address - Phone:954-288-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3644106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist