Provider Demographics
NPI:1417018763
Name:GUERRA-MORALES, AILEEN
Entity Type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:
Last Name:GUERRA-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 1:211 W DUNLOP RD
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-1741
Mailing Address - Country:US
Mailing Address - Phone:989-386-3826
Mailing Address - Fax:
Practice Address - Street 1:789 N CLARE AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625-9194
Practice Address - Country:US
Practice Address - Phone:989-539-2141
Practice Address - Fax:989-539-2143
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional