Provider Demographics
NPI:1598001448
Name:MORANTES, STELLA A (MS)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:A
Last Name:MORANTES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 BRIARHEATH DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-9503
Mailing Address - Country:US
Mailing Address - Phone:630-973-3565
Mailing Address - Fax:
Practice Address - Street 1:1747 BRIARHEATH DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-9503
Practice Address - Country:US
Practice Address - Phone:630-973-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1915488103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool