Provider Demographics
NPI:1538755897
Name:MORALES QUINONES, ANIXA MARIE (MSW)
Entity type:Individual
Prefix:
First Name:ANIXA
Middle Name:MARIE
Last Name:MORALES QUINONES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1245
Mailing Address - Country:US
Mailing Address - Phone:787-513-4301
Mailing Address - Fax:
Practice Address - Street 1:CARR 181 KM 56.9
Practice Address - Street 2:BO QUEBRADA NEGRITO
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-513-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14354104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRMSWOther14354