Provider Demographics
NPI:1821716614
Name:MORALES BOSCIO, ANA M (PHD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:MORALES BOSCIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 AVE MAGDALENA APT 602
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2138
Mailing Address - Country:US
Mailing Address - Phone:939-717-0198
Mailing Address - Fax:
Practice Address - Street 1:601 CALLE DEL PARQUE STE 302
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2319
Practice Address - Country:US
Practice Address - Phone:787-307-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist