Provider Demographics
NPI:1679347678
Name:MORALES, DEVONLEIGH ROSE
Entity Type:Individual
Prefix:MRS
First Name:DEVONLEIGH
Middle Name:ROSE
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 FIELDSTON RD APT 63B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2590
Mailing Address - Country:US
Mailing Address - Phone:914-563-7248
Mailing Address - Fax:
Practice Address - Street 1:5400 FIELDSTON RD APT 63B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2590
Practice Address - Country:US
Practice Address - Phone:914-563-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty