Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 4021 | PR |
Y | 103G00000X | Clinical Psychologist | 4021 | PR |
Y | 103TC0700X | Clinical Psychologist | 4021 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4021 | PR |
N | 103TF0000X | Family Psychologist | 4021 | PR |
N | 103TM1800X | Intellectual & Developmental Disabilities | 4021 | PR |
N | 103TP2701X | Group Psychotherapist | 4021 | PR |
NPI | 1083965883 |
---|---|
Provider Name | Dr. Lourdes Morales |
First Address | San Juan, PR 00926 |
Second Address | San Juan, PR 00926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 20/09/2012 |