Provider Demographics
NPI:1457591984
Name:MORALES, MADELINE (MS)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:
Last Name: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:CONDOMINIO SKY TOWER 1 APTO. 15 B CALLE HORTENSIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00926
Mailing Address - Country:UM
Mailing Address - Phone:787-568-6979
Mailing Address - Fax:787-706-7945
Practice Address - Street 1:1324 CALLE CANADA
Practice Address - Street 2:DE DIEGO AVENUE
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00928-1414
Practice Address - Country:UM
Practice Address - Phone:787-793-1828
Practice Address - Fax:787-706-7945
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000980103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist