Provider Demographics
NPI:1043997588
Name:MORALES, LISANGELA (DRA)
Entity Type:Individual
Prefix:
First Name:LISANGELA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:DRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 URB CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-9354
Mailing Address - Country:US
Mailing Address - Phone:939-325-0373
Mailing Address - Fax:
Practice Address - Street 1:10 URB CAMINO REAL
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-9354
Practice Address - Country:US
Practice Address - Phone:939-325-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7720103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling