Provider Demographics
NPI:1619203023
Name:MORALES-NAVEDO, LIZETTE (PSY)
Entity Type:Individual
Prefix:MRS
First Name:LIZETTE
Middle Name:
Last Name:MORALES-NAVEDO
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 16517
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-6517
Mailing Address - Country:US
Mailing Address - Phone:787-547-1636
Mailing Address - Fax:787-723-5090
Practice Address - Street 1:#1451 ASHFORD AVE. SUITE 609
Practice Address - Street 2:LA GALERIA,
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1567
Practice Address - Country:US
Practice Address - Phone:787-725-8534
Practice Address - Fax:787-723-5090
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3387103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling