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Mrs. Tera Conerly Moreno, PT
Specialist in Ponchatoula, Louisiana
NPI 1366735938

Tera Conerly Moreno is a Specialist based in Ponchatoula, LA. Tera Conerly Moreno practices in Ponchatoula, LA and has the professional credentials of PT. The NPI Number for Tera Conerly Moreno is 1366735938 and holds a License No. 02657 (Louisiana).

The current practice location address for Tera Conerly Moreno is 39336 Oaklyn Dr, Ponchatoula, LA and can be reached out via phone at 985-507-6349.

Location: 39336 Oaklyn Dr, Ponchatoula, LA, 70454-7094
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366735938
Provider Name
Tera Conerly Moreno
Credential
PT
Provider Entity Type
Individual
Gender
Female
Address
39336 Oaklyn Dr, Ponchatoula, LA, 70454-7094
Phone Number
985-507-6349
Fax Number
Provider Enumeration Date
05/16/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1479373 05 LA
institution
Provider Business Practice Location Address Details
Address
39336 Oaklyn Dr
City
Ponchatoula
State
Louisiana
Zip
70454-7094
Phone Number
985-507-6349
Fax Number
person
Provider Business Mailing Address Details
Address
39336 Oaklyn Dr
City
Ponchatoula
State
Louisiana
Zip
70454-7094
Phone Number
985-507-6349
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
02657 (Louisiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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