Provider Demographics
NPI:1477805547
Name:MORALES, JESSICA I (PSYD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:I
Last Name:MORALES
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:URBANIZACION LAS PRADERAS
Mailing Address - Street 2:1240 CALLE AGUAMARINA
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617
Mailing Address - Country:US
Mailing Address - Phone:787-420-0551
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE PATRON
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3021
Practice Address - Country:US
Practice Address - Phone:787-862-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4296103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical