Provider Demographics
NPI:1417189259
Name:MORALES NEGRON, MARANGELIE (PSYD)
Entity Type:Individual
Prefix:
First Name:MARANGELIE
Middle Name:
Last Name:MORALES NEGRON
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:PO BOX 800506
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0506
Mailing Address - Country:US
Mailing Address - Phone:787-243-9884
Mailing Address - Fax:
Practice Address - Street 1:1484 PASEO FAGOT
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2304
Practice Address - Country:US
Practice Address - Phone:787-840-4460
Practice Address - Fax:787-840-4069
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3439103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical