Healthcare Provider Details

I. General information

NPI: 1417189259
Provider Name (Legal Business Name): MARANGELIE MORALES NEGRON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1484 PASEO FAGOT
PONCE PR
00716-2304
US

IV. Provider business mailing address

PO BOX 800506
COTO LAUREL PR
00780-0506
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-4460
  • Fax: 787-840-4069
Mailing address:
  • Phone: 787-243-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3439
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: