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General NPI Number Information
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NPI Number | 1124867841
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Entity Type | Individual
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Provider Name | CELIS J AGOSTO-MORALES MSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | AVE JOSE SEVERO QUINONES B146 CALLE 2
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-514-2182
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Fax |
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Provider Business Mailing Address
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Address Line | COND VISTA VERDE EDIF H APT 110
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-514-2182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 16478
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License Number State | PR
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