Provider Demographics
NPI:1689075962
Name:MORALES, MIGUEL SR
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:MORALES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-5054
Mailing Address - Country:US
Mailing Address - Phone:978-397-0602
Mailing Address - Fax:
Practice Address - Street 1:56 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-5054
Practice Address - Country:US
Practice Address - Phone:978-397-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor