Healthcare Provider Details

I. General information

NPI: 1093649873
Provider Name (Legal Business Name): NURIA L DEL MORAL DE LEON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E36 CALLE HERNANDEZ CARRION
MANATI PR
00674-4622
US

IV. Provider business mailing address

E36 CALLE HERNANDEZ CARRION
MANATI PR
00674-4622
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-4477
  • Fax: 787-884-4495
Mailing address:
  • Phone: 787-884-4477
  • Fax: 787-884-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number9019
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: