MEDICARE: MS. EVELYN RUTH MORALES M.ED, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	0232	NC

General Provider Information

NPI Number	:	1750541348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVELYN RUTH MORALES M.ED, LPC

Provider Business Mailing Address
First Line	:	2009 HICKSWOOD RD
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9574
Country	:	US
Telephone Number	:	336-454-2295
Fax Number	:	336-454-0579

Provider Business Practice Location Address
First Line	:	2009 HICKSWOOD RD
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9574
Country	:	US
Telephone Number	:	336-454-2295
Fax Number	:	336-454-0579

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	06/17/2008

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