Provider Demographics
NPI:1295019420
Name:MORA RODRIGUEZ, SARAI MILAGROS
Entity Type:Individual
Prefix:
First Name:SARAI
Middle Name:MILAGROS
Last Name:MORA RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4960
Mailing Address - Street 2:PMB 413
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-413-1331
Mailing Address - Fax:787-738-7455
Practice Address - Street 1:101 SUR CALLE CORCHADO
Practice Address - Street 2:ESQUINA NUNEZ ROMEU
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4718
Practice Address - Country:US
Practice Address - Phone:787-738-7455
Practice Address - Fax:787-738-7455
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3909103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling