Provider Demographics
NPI:1932879186
Name:LUGO-MORALES, WILBETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILBETH
Middle Name:
Last Name:LUGO-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 1:2898 BOAT HOUSE BLVD UNIT 209
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4397
Mailing Address - Country:US
Mailing Address - Phone:787-238-9060
Mailing Address - Fax:
Practice Address - Street 1:2898 BOAT HOUSE BLVD UNIT 209
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4397
Practice Address - Country:US
Practice Address - Phone:787-238-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38709103T00000X
TX71656103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool