Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 2715 | GA |
N | 103T00000X | Psychologist | 2715 | GA |
N | 102L00000X | Psychologist | PS016017 | PA |
N | 103T00000X | Psychologist | PS016017 | PA |
N | 102L00000X | Psychologist | PY 6925 | FL |
N | 103T00000X | Psychologist | PY 6925 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY 6925 |
NPI | 1548245756 |
---|---|
Provider Name | Dr. Roberto Morales |
First Address | Pottstown, PA 19464-3211 |
Second Address | Pottstown, PA 19464-3211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 08/07/2007 |