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General NPI Number Information
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NPI Number | 1174056717
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Entity Type | Individual
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Provider Name | JENNIFER MORALES CRUZ PHD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 1801 AVE PONCE DE LEON STE 411
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City | SAN JUAN
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State | PR
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Zip | 00909-1917
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Country | US
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Telephone | 787-922-4664
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Fax |
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Provider Business Mailing Address
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Address Line | 475 CALLE CESAR GONZALEZ
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City | SAN JUAN
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State | PR
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Zip | 00918-2637
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Country | US
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Telephone | 787-922-4664
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5835
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License Number State | PR
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