Provider Demographics
NPI:1548597578
Name:MORALES, KENIA MARIA (MS CCC-SLP 900)
Entity Type:Individual
Prefix:MISS
First Name:KENIA
Middle Name:MARIA
Last Name:MORALES
Suffix:
Gender:F
Credentials:MS CCC-SLP 900
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 CAMINO DE LOS JAZMINES
Mailing Address - Street 2:VEREDAS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9064
Mailing Address - Country:US
Mailing Address - Phone:787-914-9103
Mailing Address - Fax:
Practice Address - Street 1:568 CAMINO DE LOS JAZMINES
Practice Address - Street 2:VEREDAS
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9064
Practice Address - Country:US
Practice Address - Phone:787-914-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist