IndividualActive
Desiree Moreno, DAT, LAT, ATC
NPI 1508221573 · Athletic Trainer · Raton, NM
Provider details
- NPI number
- 1508221573
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- DAT, LAT, ATC
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Athletic Trainer2255A2300X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1356 Vista Pl
Raton, NM 87740-2221
Phone: (715) 554-2728
Approximate (ZIP-level) locationGet directions
Mailing address
723 W Jefferson St
Trinidad, CO 81082-3667
Registry dates
- Enumerated
- 2015-12-17
- Last updated
- 2024-05-22
- Certified
- 2024-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.