Provider Demographics
NPI:1225211444
Name:MORALES MOLL, MOLLY MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:MARIE
Last Name:MORALES MOLL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 COND. ALBORADA
Mailing Address - Street 2:APART. 2822
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-510-1000
Mailing Address - Fax:
Practice Address - Street 1:1225 COND. ALBORADA
Practice Address - Street 2:APART. 2822
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-510-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1921103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical