Provider Demographics
NPI:1245522523
Name:NEGRON MORALES, LYAN M
Entity type:Individual
Prefix:MS
First Name:LYAN
Middle Name:M
Last Name:NEGRON 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:HC 04 BOX 43025
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0669
Mailing Address - Country:US
Mailing Address - Phone:787-201-5672
Mailing Address - Fax:
Practice Address - Street 1:HC 04 BOX 43025
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-1262
Practice Address - Country:US
Practice Address - Phone:787-201-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14502355S0801X
PR3061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant