Provider Demographics
NPI:1558637215
Name:MORALES RAMOS, DANITA (PHD)
Entity type:Individual
Prefix:DR
First Name:DANITA
Middle Name:
Last Name:MORALES RAMOS
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 1:900 COMMONWEALTH PL STE 104
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4517
Mailing Address - Country:US
Mailing Address - Phone:757-937-2123
Mailing Address - Fax:757-782-9003
Practice Address - Street 1:AZZ-ERT URSELF INC
Practice Address - Street 2:900 COMMONWEALTH PL STE 104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4517
Practice Address - Country:US
Practice Address - Phone:757-937-2123
Practice Address - Fax:757-782-9003
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0701007062101YP2500X
VA0701007062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA601155180Medicaid