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General NPI Number Information
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NPI Number | 1689128464
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Entity Type | Organization
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Legal Business Name | CLINICA DE SERVICIOS PSICOLOGICOS DRA MORALES CASANAS, CSP
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | G2514 PASEO AMPARO LEVITTOWN LAKES
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-545-2400
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Fax | 787-545-2400
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Provider Business Mailing Address
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Address Line | G2514 PASEO AMPARO LEVITTOWN LAKES
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-545-2400
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Fax | 787-545-2400
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NIRETZY MORALES
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Credential |
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Telephone | 787-545-2400
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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 | 2878
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License Number State | PR
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