Provider Demographics
NPI:1396188462
Name:CRUZ MORALES, RICARDO SR (MPSY)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:CRUZ MORALES
Suffix:SR
Gender:M
Credentials:MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 VERDE MAR ST.43
Mailing Address - Street 2:PUNTA SANTIAGO
Mailing Address - City:HUMACAO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00741
Mailing Address - Country:UM
Mailing Address - Phone:787-469-8625
Mailing Address - Fax:
Practice Address - Street 1:991 VERDE MAR ST.43
Practice Address - Street 2:
Practice Address - City:PUNTA SANTIAGO
Practice Address - State:PR
Practice Address - Zip Code:00741-2525
Practice Address - Country:US
Practice Address - Phone:787-469-8625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4255103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling