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General NPI Number Information
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NPI Number | 1336404813
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Entity Type | Individual
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Provider Name | JANNETTE MARIE MORALES RIVERA PH. D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | HC 2 BOX 9429
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City | JUANA DIAZ
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State | PR
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Zip | 00795-9676
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Country | US
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Telephone | 787-448-7401
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Fax | 787-844-4569
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Provider Business Mailing Address
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Address Line | URBANIZACION LA RAMBLA 1901 CALLE MURCIA
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City | PONCE
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State | PR
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Zip | 00730-4062
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Country | US
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Telephone | 787-488-7401
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Fax | 787-844-4569
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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 | 4299
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License Number State | PR
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