Provider Demographics
NPI:1003503574
Name:MORALES, KRYSTIANA (MSW)
Entity Type:Individual
Prefix:
First Name:KRYSTIANA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E SOUTH TEMPLE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1234
Mailing Address - Country:US
Mailing Address - Phone:253-380-0900
Mailing Address - Fax:
Practice Address - Street 1:314 W BROADWAY STE 222
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2038
Practice Address - Country:US
Practice Address - Phone:801-896-7229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical