Provider Demographics
NPI:1639817539
Name:MORALES, KARINA LYNN (PHD)
Entity type:Individual
Prefix:MS
First Name:KARINA
Middle Name:LYNN
Last Name:MORALES
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 1:12 BREVOORT DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3074
Mailing Address - Country:US
Mailing Address - Phone:845-596-6730
Mailing Address - Fax:
Practice Address - Street 1:12 BREVOORT DR APT 1B
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3074
Practice Address - Country:US
Practice Address - Phone:845-596-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool