Provider Demographics
NPI:1619102274
Name:MORANT, RODNIE (PHD)
Entity Type:Individual
Prefix:
First Name:RODNIE
Middle Name:
Last Name:MORANT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A28, C2
Mailing Address - Street 2:URB. SAN FRANCISCO JAVIER
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-399-1849
Mailing Address - Fax:
Practice Address - Street 1:A28, C2
Practice Address - Street 2:URB SAN FRANCISCO JAVIER
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:UM
Practice Address - Phone:787-399-1849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical