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General NPI Number Information
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NPI Number | 1588152136
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Entity Type | Individual
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Provider Name | MORELLA MORALES DE DIQUEZ
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 500 FAIRWAY DR STE 102
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1817
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Country | US
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Telephone | 754-264-0838
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Fax |
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Provider Business Mailing Address
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Address Line | 525 N TRYON ST
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City | CHARLOTTE
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State | NC
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Zip | 28202-0202
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Country | US
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Telephone | 855-832-6727
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | A672
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License Number State | NC
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