Provider Demographics
NPI:1205328986
Name:NUNEZ MORALES, AGLAURY (MS)
Entity type:Individual
Prefix:
First Name:AGLAURY
Middle Name:
Last Name:NUNEZ MORALES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S ROLLIE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1508
Mailing Address - Country:US
Mailing Address - Phone:303-892-6401
Mailing Address - Fax:303-286-4589
Practice Address - Street 1:220 E ROGERS RD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6027
Practice Address - Country:US
Practice Address - Phone:303-697-2583
Practice Address - Fax:303-682-6419
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
COPSY.0005629103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program