Provider Demographics
NPI:1720007370
Name:MORALES, MAYRA (MSW)
Entity Type:Individual
Prefix:MS
First Name:MAYRA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 CALLE LOVAINA
Mailing Address - Street 2:URB. COLLEGE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4819
Mailing Address - Country:US
Mailing Address - Phone:787-299-7047
Mailing Address - Fax:
Practice Address - Street 1:10 CASIA STRRETT
Practice Address - Street 2:VA CARIBBEAN HEALTHCARE SYSTEM
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00933-3201
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-4398
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical