Provider Demographics
NPI:1124390026
Name:MORALES, MARIA JASMIN (LADC I)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JASMIN
Last Name:MORALES
Suffix:
Gender:F
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WAUMSETT AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5815
Mailing Address - Country:US
Mailing Address - Phone:580-977-3767
Mailing Address - Fax:
Practice Address - Street 1:THE BATES BUILDING, 7 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:401-300-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health