Provider Demographics
NPI:1407638174
Name:MORALES, CYRENE ANGELIQUE
Entity Type:Individual
Prefix:MISS
First Name:CYRENE
Middle Name:ANGELIQUE
Last Name:MORALES
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 1:8630 S 69TH DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-4556
Mailing Address - Country:US
Mailing Address - Phone:602-850-1554
Mailing Address - Fax:
Practice Address - Street 1:2201 E BROADWAY RD APT B5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2665
Practice Address - Country:US
Practice Address - Phone:602-850-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care